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Shepard S, Sajjadi NB, Checketts JX, Hughes G, Ottwell R, Chalkin B, Hartwell M, Vassar M. Examining the Public's Most Frequently Asked Questions About Carpal Tunnel Syndrome and Appraising Online Information About Treatment. Hand (N Y) 2024; 19:768-775. [PMID: 36564990 DOI: 10.1177/15589447221142895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Patients often search online for health information regarding common musculoskeletal complaints. Thus, the purpose of this study was to use language processing information from Google to assess the content of CTS frequently asked questions (FAQs) searched online and the transparency and quality of online CTS information. METHODS On March 11, 2021, we searched Google for 3 terms "carpal tunnel syndrome treatment," "carpal tunnel syndrome surgical treatment," and "carpal tunnel syndrome non-surgical treatment" until a minimum of 100 FAQs and their answer links were extracted from each search. We used Rothwell classification to categorize the FAQs. The Journal of the American Medical Association's benchmark criteria were used to assess information transparency. Information quality was assessed using the Brief DISCERN tool. RESULTS Our Google search returned 124 unique FAQs. Fifty-six (45.2%) were value based and most were related to the evaluation of treatment options (45/56, 80.4%). The most common source type was medical practices (26.6%). Nearly half of the answer sources (45.9%) were found to be lacking in transparency. One-way analysis of variance revealed a significant difference in mean Brief DISCERN scores among the 5 source types, F(4, 119) = 5.93, P = .0002, with medical practices averaging the worst score (13.73/30). CONCLUSIONS Patients are most commonly searching Google to gain information regarding CTS treatment options. Online sources such as medical practices should use widely accepted rubrics for ensuring transparency and quality prior to publishing CTS information.
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Affiliation(s)
- Samuel Shepard
- Oklahoma State University Center for Health Sciences, Tulsa, USA
| | | | | | - Griffin Hughes
- Oklahoma State University Center for Health Sciences, Tulsa, USA
| | | | - Brian Chalkin
- Oklahoma State University Medical Center, Tulsa, USA
| | - Micah Hartwell
- Oklahoma State University Center for Health Sciences, Tulsa, USA
| | - Matt Vassar
- Oklahoma State University Center for Health Sciences, Tulsa, USA
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Kasthuri VS, Glueck J, Pham H, Daher M, Balmaceno-Criss M, McDonald CL, Diebo BG, Daniels AH. Assessing the Accuracy and Reliability of AI-Generated Responses to Patient Questions Regarding Spine Surgery. J Bone Joint Surg Am 2024; 106:1136-1142. [PMID: 38335266 DOI: 10.2106/jbjs.23.00914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
BACKGROUND In today's digital age, patients increasingly rely on online search engines for medical information. The integration of large language models such as GPT-4 into search engines such as Bing raises concerns over the potential transmission of misinformation when patients search for information online regarding spine surgery. METHODS SearchResponse.io, a database that archives People Also Ask (PAA) data from Google, was utilized to determine the most popular patient questions regarding 4 specific spine surgery topics: anterior cervical discectomy and fusion, lumbar fusion, laminectomy, and spinal deformity. Bing's responses to these questions, along with the cited sources, were recorded for analysis. Two fellowship-trained spine surgeons assessed the accuracy of the answers on a 6-point scale and the completeness of the answers on a 3-point scale. Inaccurate answers were re-queried 2 weeks later. Cited sources were categorized and evaluated against Journal of the American Medical Association (JAMA) benchmark criteria. Interrater reliability was measured with use of the kappa statistic. A linear regression analysis was utilized to explore the relationship between answer accuracy and the type of source, number of sources, and mean JAMA benchmark score. RESULTS Bing's responses to 71 PAA questions were analyzed. The average completeness score was 2.03 (standard deviation [SD], 0.36), and the average accuracy score was 4.49 (SD, 1.10). Among the question topics, spinal deformity had the lowest mean completeness score. Re-querying the questions that initially had answers with low accuracy scores resulted in responses with improved accuracy. Among the cited sources, commercial sources were the most prevalent. The JAMA benchmark score across all sources averaged 2.63. Government sources had the highest mean benchmark score (3.30), whereas social media had the lowest (1.75). CONCLUSIONS Bing's answers were generally accurate and adequately complete, with incorrect responses rectified upon re-querying. The plurality of information was sourced from commercial websites. The type of source, number of sources, and mean JAMA benchmark score were not significantly correlated with answer accuracy. These findings underscore the importance of ongoing evaluation and improvement of large language models to ensure reliable and informative results for patients seeking information regarding spine surgery online amid the integration of these models in the search experience.
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Affiliation(s)
- Viknesh S Kasthuri
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Jacob Glueck
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Han Pham
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Mohammad Daher
- Department of Orthopedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Mariah Balmaceno-Criss
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Department of Orthopedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Christopher L McDonald
- Department of Orthopedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Bassel G Diebo
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Department of Orthopedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Alan H Daniels
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Department of Orthopedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island
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Lim B, Chai A, Shaalan M. A Cross-Sectional Analysis of the Readability of Online Information Regarding Hip Osteoarthritis. Cureus 2024; 16:e60536. [PMID: 38887325 PMCID: PMC11181007 DOI: 10.7759/cureus.60536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2024] [Indexed: 06/20/2024] Open
Abstract
Introduction Osteoarthritis (OA) is an age-related degenerative joint disease. There is a 25% risk of symptomatic hip OA in patients who live up to 85 years of age. It can impair a person's daily activities and increase their reliance on healthcare services. It is primarily managed with education, weight loss and exercise, supplemented with pharmacological interventions. Poor health literacy is associated with negative treatment outcomes and patient dissatisfaction. A literature search found there are no previously published studies examining the readability of online information about hip OA. Objectives To assess the readability of healthcare websites regarding hip OA. Methods The terms "hip pain", "hip osteoarthritis", "hip arthritis", and "hip OA" were searched on Google and Bing. Of 240 websites initially considered, 74 unique websites underwent evaluation using the WebFX online readability software (WebFX®, Harrisburg, USA). Readability was determined using the Flesch Reading Ease Score (FRES), Flesch-Kincaid Reading Grade Level (FKGL), Gunning Fog Index (GFI), Simple Measure of Gobbledygook (SMOG), Coleman-Liau Index (CLI), and Automated Readability Index (ARI). In line with recommended guidelines and previous studies, FRES >65 or a grade level score of sixth grade and under was considered acceptable. Results The average FRES was 56.74±8.18 (range 29.5-79.4). Only nine (12.16%) websites had a FRES score >65. The average FKGL score was 7.62±1.69 (range 4.2-12.9). Only seven (9.46%) websites were written at or below a sixth-grade level according to the FKGL score. The average GFI score was 9.20±2.09 (range 5.6-16.5). Only one (1.35%) website was written at or below a sixth-grade level according to the GFI score. The average SMOG score was 7.29±1.41 (range 5.4-12.0). Only eight (10.81%) websites were written at or below a sixth-grade level according to the SMOG score. The average CLI score was 13.86±1.75 (range 9.6-19.7). All 36 websites were written above a sixth-grade level according to the CLI score. The average ARI score was 6.91±2.06 (range 3.1-14.0). Twenty-eight (37.84%) websites were written at or below a sixth-grade level according to the ARI score. One-sample t-tests showed that FRES (p<0.001, CI -10.2 to -6.37), FKGL (p<0.001, CI 1.23 to 2.01), GFI (p<0.001, CI 2.72 to 3.69), SMOG (p<0.001, CI 0.97 to 1.62), CLI (p<0.001, CI 7.46 to 8.27), and ARI (p<0.001, CI 0.43 to 1.39) scores were significantly different from the accepted standard. One-way analysis of variance (ANOVA) testing of FRES scores (p=0.009) and CLI scores (p=0.009) showed a significant difference between categories. Post hoc testing showed a significant difference between academic and non-profit categories for FRES scores (p=0.010, CI -15.17 to -1.47) and CLI scores (p=0.008, CI 0.35 to 3.29). Conclusions Most websites regarding hip OA are written above recommended reading levels, hence exceeding the comprehension levels of the average patient. Readability of these resources must be improved to improve patient access to online healthcare information which can lead to improved patient understanding of their own condition and treatment outcomes.
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Affiliation(s)
- Brandon Lim
- Department of Medicine, School of Medicine, Trinity College Dublin, Dublin, IRL
| | - Ariel Chai
- Department of Medicine, School of Medicine, Trinity College Dublin, Dublin, IRL
| | - Mohamed Shaalan
- Department of Orthopaedics and Traumatology, The Mater Misericordiae University Hospital, Dublin, IRL
- Department of Trauma and Orthopaedics, St James's Hospital, Dublin, IRL
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Obana KK, Lind DR, Mastroianni MA, Rondon AJ, Alexander FJ, Levine WN, Ahmad CS. What are our patients asking Google about acromioclavicular joint injuries?-frequently asked online questions and the quality of online resources. JSES REVIEWS, REPORTS, AND TECHNIQUES 2024; 4:175-181. [PMID: 38706686 PMCID: PMC11065754 DOI: 10.1016/j.xrrt.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Background Management of acromioclavicular (AC) joint injuries has been an ongoing source of debate, with over 150 variations of surgery described in the literature. Without a consensus on surgical technique, patients are seeking answers to common questions through internet resources. This study investigates the most common online patient questions pertaining to AC joint injuries and the quality of the websites providing information. Hypothesis 1) Question topics will pertain to surgical indications, pain management, and success of surgery and 2) the quality and transparency of online information are largely heterogenous. Methods Three AC joint search queries were entered into the Google Web Search. Questions under the "People also ask" tab were expanded in order and 100 results for each query were included (300 total). Questions were categorized based on Rothwell's classification. Websites were categorized by source. Website quality was evaluated by the Journal of the American Medical Association (JAMA) Benchmark Criteria. Results Most questions fell into the Rothwell Fact category (48.0%). The most common question topics were surgical indications (28.0%), timeline of recovery (13.0%), and diagnosis/evaluation (12.0%). The least common question topics were anatomy/function (3.3%), evaluation of surgery (3.3%), injury comparison (1.0%), and cost (1.0%). The most common websites were medical practice (44.0%), academic (22.3%), and single surgeon personal (12.3%). The average JAMA score for all websites was 1.0 ± 1.3. Government websites had the highest JAMA score (4.0 ± 0.0) and constituted 45.8% of all websites with a score of 4/4. PubMed articles constituted 63.6% (7/11) of government website. Comparatively, medical practice websites had the lowest JAMA score (0.3 ± 0.7, range [0-3]). Conclusion Online patient AC joint injury questions pertain to surgical indications, timeline of recovery, and diagnosis/evaluation. Government websites and PubMed articles provide the highest-quality sources of reliable, up-to-date information but constitute the smallest proportion of resources. In contrast, medical practice represents the most visited websites, however, recorded the lowest quality score. Physicians should utilize this information to answer frequently asked questions, guide patient expectations, and help provide and identify reliable online resources.
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Affiliation(s)
- Kyle K. Obana
- Department of Orthopaedic Surgery, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, USA
| | - Dane R.G. Lind
- Department of Orthopaedic Surgery, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, USA
| | - Michael A. Mastroianni
- Department of Orthopaedic Surgery, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, USA
| | - Alexander J. Rondon
- Department of Orthopaedic Surgery, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, USA
| | - Frank J. Alexander
- Department of Orthopaedic Surgery, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, USA
| | - William N. Levine
- Department of Orthopaedic Surgery, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, USA
| | - Christopher S. Ahmad
- Department of Orthopaedic Surgery, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, USA
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Yang J, Ardavanis KS, Slack KE, Fernando ND, Della Valle CJ, Hernandez NM. Chat Generative Pretrained Transformer (ChatGPT) and Bard: Artificial Intelligence Does not yet Provide Clinically Supported Answers for Hip and Knee Osteoarthritis. J Arthroplasty 2024; 39:1184-1190. [PMID: 38237878 DOI: 10.1016/j.arth.2024.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Advancements in artificial intelligence (AI) have led to the creation of large language models (LLMs), such as Chat Generative Pretrained Transformer (ChatGPT) and Bard, that analyze online resources to synthesize responses to user queries. Despite their popularity, the accuracy of LLM responses to medical questions remains unknown. This study aimed to compare the responses of ChatGPT and Bard regarding treatments for hip and knee osteoarthritis with the American Academy of Orthopaedic Surgeons (AAOS) Evidence-Based Clinical Practice Guidelines (CPGs) recommendations. METHODS Both ChatGPT (Open AI) and Bard (Google) were queried regarding 20 treatments (10 for hip and 10 for knee osteoarthritis) from the AAOS CPGs. Responses were classified by 2 reviewers as being in "Concordance," "Discordance," or "No Concordance" with AAOS CPGs. A Cohen's Kappa coefficient was used to assess inter-rater reliability, and Chi-squared analyses were used to compare responses between LLMs. RESULTS Overall, ChatGPT and Bard provided responses that were concordant with the AAOS CPGs for 16 (80%) and 12 (60%) treatments, respectively. Notably, ChatGPT and Bard encouraged the use of non-recommended treatments in 30% and 60% of queries, respectively. There were no differences in performance when evaluating by joint or by recommended versus non-recommended treatments. Studies were referenced in 6 (30%) of the Bard responses and none (0%) of the ChatGPT responses. Of the 6 Bard responses, studies could only be identified for 1 (16.7%). Of the remaining, 2 (33.3%) responses cited studies in journals that did not exist, 2 (33.3%) cited studies that could not be found with the information given, and 1 (16.7%) provided links to unrelated studies. CONCLUSIONS Both ChatGPT and Bard do not consistently provide responses that align with the AAOS CPGs. Consequently, physicians and patients should temper expectations on the guidance AI platforms can currently provide.
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Affiliation(s)
- JaeWon Yang
- Department of Orthopaedic Surgery, University of Washington, Seattle, Washington
| | - Kyle S Ardavanis
- Department of Orthopaedic Surgery, Madigan Medical Center, Tacoma, Washington
| | - Katherine E Slack
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington
| | - Navin D Fernando
- Department of Orthopaedic Surgery, University of Washington, Seattle, Washington
| | - Craig J Della Valle
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Nicholas M Hernandez
- Department of Orthopaedic Surgery, University of Washington, Seattle, Washington
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Ferrell SC, Ferrell MC, Nelson CM, Lippard JS, Beaman J, Vassar M. Understanding Public Perception of Naloxone: A Study of FAQs and Answer Source Credibility. Subst Use Misuse 2024; 59:1352-1356. [PMID: 38688898 DOI: 10.1080/10826084.2024.2341319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
PURPOSE The most commonly used intervention for opioid overdoses is naloxone. With naloxone soon to be sold over-the-counter in the United States, the goal of this paper is to categorize frequently asked questions (FAQs) and answers about naloxone using internet sources in a cross-sectional fashion. METHODS Terms "narcan" and "naloxone" were searched on a clean Google Chrome browser using the "People also asked" tab to find FAQs and their answer sources. We classified questions and sources and assessed each website's quality and credibility grading with JAMA benchmark criteria. The Kruskal-Wallis H test was used to determine variance of mean JAMA score by source type and Post-Hoc Dunn's test with Bonferroni corrected alpha of 0.005 used to compare source types. RESULTS Of the 305 unique questions, 202 (66.2%) were classified as facts, 78 (25.6%) were policy, and 25 (8.2%) were value. Of the 144 unique answer sources, the two most common included 55 (38.2%) which were government entities and 47 (32.6%) which were commercial entities. Ninety-two (of 144, 63.9%) sources met three or more JAMA benchmark criteria. Statistical analysis showed a significant difference between the JAMA benchmark scores by source type H(4) = 12.75, p = 0.0126 and between the mean rank of academic and government sources (p = 0.0036). CONCLUSION We identified FAQs and their citations about naloxone, highlighting potential lack of understanding and knowledge of this important intervention. We recommend updating websites to accurately reflect current and useful information for those that may require naloxone.
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Affiliation(s)
- Sydney C Ferrell
- Department of Internal Medicine, The University of Vermont Medical Center, Burlington, Vermont, USA
| | - Matthew C Ferrell
- Department of Internal Medicine, The University of Vermont Medical Center, Burlington, Vermont, USA
| | - Cole M Nelson
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Justin S Lippard
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Jason Beaman
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
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Obana KK, Law C, Mastroianni MA, Abdelaziz A, Alexander FJ, Ahmad CS, Trofa DP. What are our patients asking google about posterior cruciate ligament injuries? - frequently asked online questions and quality of online resources. PHYSICIAN SPORTSMED 2024. [PMID: 38651524 DOI: 10.1080/00913847.2024.2346462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 04/19/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVES This study investigates the most common online patient questions pertaining to posterior cruciate ligament (PCL) injuries and the quality of the websites providing information. METHODS Four PCL search queries were entered into the Google Web Search. Questions under the 'People also ask' tab were expanded in order and 100 results for each query were included (400 total). Questions were categorized based on Rothwell's Classification of Questions (Fact, Policy, Value). Websites were categorized by source (Academic, Commercial, Government, Medical Practice, Single Surgeon Personal, Social Media). Website quality was evaluated based on the Journal of the American Medical Association (JAMA) Benchmark Criteria. Pearson's chi-squared was used to assess categorical data. Cohen's kappa was used to assess inter-rater reliability. RESULTS Most questions fell into the Rothwell Fact category (54.3%). The most common question topics were Diagnosis/Evaluation (18.0%), Indications/Management (15.5%), and Timeline of Recovery (15.3%). The least common question topics were Technical Details of Procedure (1.5%), Cost (0.5%), and Longevity (0.5%). The most common websites were Medical Practice (31.8%) and Commercial (24.3%), while the least common were Government (8.5%) and Social Media (1.5%). The average JAMA score for websites was 1.49 ± 1.36. Government websites had the highest JAMA score (3.00 ± 1.26) and constituted 42.5% of all websites with a score of 4/4. Comparatively, Single Surgeon Personal websites had the lowest JAMA score (0.76 ± 0.87, range [0-2]). PubMed articles constituted 70.6% (24/34) of Government websites, 70.8% (17/24) had a JAMA score of 4 and 20.8% (5/24) had a score of 3. CONCLUSION Patients search the internet for information regarding diagnosis, treatment, and recovery of PCL injuries and are less interested in the details of the procedure, cost, and longevity of treatment. The low JAMA score reflects the heterogenous quality and transparency of online information. Physicians can use this information to help guide patient expectations pre- and post-operatively.
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Affiliation(s)
- Kyle K Obana
- Department of Orthopaedic Surgery, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY
| | - Christian Law
- Department of Orthopaedic Surgery, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY
| | - Michael A Mastroianni
- Department of Orthopaedic Surgery, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY
| | - Abed Abdelaziz
- Department of Orthopaedic Surgery, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY
| | - Frank J Alexander
- Department of Orthopaedic Surgery, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY
| | - Christopher S Ahmad
- Department of Orthopaedic Surgery, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY
| | - David P Trofa
- Department of Orthopaedic Surgery, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY
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Mastrokostas PG, Mastrokostas LE, Emara AK, Wellington IJ, Ginalis E, Houten JK, Khalsa AS, Saleh A, Razi AE, Ng MK. Modern Internet Search Analytics: Is There a Difference in What Patients are Searching Regarding the Operative and Nonoperative Management of Scoliosis? Global Spine J 2024:21925682241248110. [PMID: 38613478 DOI: 10.1177/21925682241248110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/15/2024] Open
Abstract
STUDY DESIGN Observational Study. OBJECTIVES This study aimed to investigate the most searched types of questions and online resources implicated in the operative and nonoperative management of scoliosis. METHODS Six terms related to operative and nonoperative scoliosis treatment were searched on Google's People Also Ask section on October 12, 2023. The Rothwell classification was used to sort questions into fact, policy, or value categories, and associated websites were classified by type. Fischer's exact tests compared question type and websites encountered between operative and nonoperative questions. Statistical significance was set at the .05 level. RESULTS The most common questions concerning operative and nonoperative management were fact (53.4%) and value (35.5%) questions, respectively. The most common subcategory pertaining to operative and nonoperative questions were specific activities/restrictions (21.7%) and evaluation of treatment (33.3%), respectively. Questions on indications/management (13.2% vs 31.2%, P < .001) and evaluation of treatment (10.1% vs 33.3%, P < .001) were associated with nonoperative scoliosis management. Medical practice websites were the most common website to which questions concerning operative (31.9%) and nonoperative (51.4%) management were directed to. Operative questions were more likely to be directed to academic websites (21.7% vs 10.0%, P = .037) and less likely to be directed to medical practice websites (31.9% vs 51.4%, P = .007) than nonoperative questions. CONCLUSIONS During scoliosis consultations, spine surgeons should emphasize the postoperative recovery process and efficacy of conservative treatment modalities for the operative and nonoperative management of scoliosis, respectively. Future research should assess the impact of website encounters on patients' decision-making.
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Affiliation(s)
- Paul G Mastrokostas
- College of Medicine, State University of New York (SUNY) Downstate, Brooklyn, NY, USA
| | | | - Ahmed K Emara
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Ian J Wellington
- Department of Orthopaedic Surgery, University of Connecticut, Hartford, CT, USA
| | | | - John K Houten
- Department of Neurosurgery, Mount Sinai School of Medicine, New York, NY, USA
| | - Amrit S Khalsa
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Ahmed Saleh
- Maimonides Medical Center, Department of Orthopaedic Surgery, Brooklyn, NY, USA
| | - Afshin E Razi
- Maimonides Medical Center, Department of Orthopaedic Surgery, Brooklyn, NY, USA
| | - Mitchell K Ng
- Maimonides Medical Center, Department of Orthopaedic Surgery, Brooklyn, NY, USA
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Ren R, Busigó Torres R, Sabo GC, Arroyave JS, Stern BZ, Chen DD, Hayden BL, Poeran J, Moucha CS. Characteristics and Quality of Online Searches for Direct Anterior Versus Posterior Approach for Total Hip Arthroplasty. J Arthroplasty 2024:S0883-5403(24)00264-X. [PMID: 38582372 DOI: 10.1016/j.arth.2024.03.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 03/16/2024] [Accepted: 03/19/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND Online resources are important for patient self-education and reflect public interest. We described commonly asked questions regarding the direct anterior versus posterior approach (DAA, PA) to total hip arthroplasty (THA) and the quality of associated websites. METHODS We extracted the top 200 questions and websites in Google's "People Also Ask" section for 8 queries on January 8, 2023, and grouped websites and questions into DAA, PA, or comparison. Questions were categorized using Rothwell's classification (fact, policy, value) and THA-relevant subtopics. Websites were evaluated by information source, Journal of the American Medical Association Benchmark Criteria (credibility), DISCERN survey (information quality), and readability. RESULTS We included 429 question/website combinations (questions: 52.2% DAA, 21.2% PA, 26.6% comparison; websites: 39.0% DAA, 11.0% PA, 9.6% comparison). Per Rothwell's classification, 56.2% of questions were fact, 31.7% value, 10.0% policy, and 2.1% unrelated. The THA-specific question subtopics differed between DAA and PA (P < .001), specifically for recovery timeline (DAA 20.5%, PA 37.4%), indications/management (DAA 13.4%, PA 1.1%), and technical details (DAA 13.8%, PA 5.5%). Information sources differed between DAA (61.7% medical practice/surgeon) and PA websites (44.7% government; P < .001). The median Journal of the American Medical Association Benchmark score was 1 (limited credibility, interquartile range 1 to 2), with the lowest scores for DAA websites (P < .001). The median DISCERN score was 55 ("good" quality, interquartile range 43 to 65), with the highest scores for comparison websites (P < .001). Median Flesch-Kincaid Grade Level scores were 12th grade level for both DAA and PA (P = .94). CONCLUSIONS Patients' informational interests can guide counseling. Internet searches that explicitly compare THA approaches yielded websites that provide higher-quality information. Providers may also advise patients that physician websites and websites only describing the DAA may have less balanced perspectives, and limited information regarding surgical approaches is available from social media resources.
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Affiliation(s)
- Renee Ren
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Rodnell Busigó Torres
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Graham C Sabo
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Juan Sebastian Arroyave
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Brocha Z Stern
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Population Health Science and Policy, Institute for Health Care Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Darwin D Chen
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Brett L Hayden
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jashvant Poeran
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Population Health Science and Policy, Institute for Health Care Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Calin S Moucha
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
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10
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Zhang S, Liau ZQG, Tan KLM, Chua WL. Evaluating the accuracy and relevance of ChatGPT responses to frequently asked questions regarding total knee replacement. Knee Surg Relat Res 2024; 36:15. [PMID: 38566254 PMCID: PMC10986046 DOI: 10.1186/s43019-024-00218-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/12/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Chat Generative Pretrained Transformer (ChatGPT), a generative artificial intelligence chatbot, may have broad applications in healthcare delivery and patient education due to its ability to provide human-like responses to a wide range of patient queries. However, there is limited evidence regarding its ability to provide reliable and useful information on orthopaedic procedures. This study seeks to evaluate the accuracy and relevance of responses provided by ChatGPT to frequently asked questions (FAQs) regarding total knee replacement (TKR). METHODS A list of 50 clinically-relevant FAQs regarding TKR was collated. Each question was individually entered as a prompt to ChatGPT (version 3.5), and the first response generated was recorded. Responses were then reviewed by two independent orthopaedic surgeons and graded on a Likert scale for their factual accuracy and relevance. These responses were then classified into accurate versus inaccurate and relevant versus irrelevant responses using preset thresholds on the Likert scale. RESULTS Most responses were accurate, while all responses were relevant. Of the 50 FAQs, 44/50 (88%) of ChatGPT responses were classified as accurate, achieving a mean Likert grade of 4.6/5 for factual accuracy. On the other hand, 50/50 (100%) of responses were classified as relevant, achieving a mean Likert grade of 4.9/5 for relevance. CONCLUSION ChatGPT performed well in providing accurate and relevant responses to FAQs regarding TKR, demonstrating great potential as a tool for patient education. However, it is not infallible and can occasionally provide inaccurate medical information. Patients and clinicians intending to utilize this technology should be mindful of its limitations and ensure adequate supervision and verification of information provided.
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Affiliation(s)
- Siyuan Zhang
- Department of Orthopaedic Surgery, National University Health System, Level 11, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore.
| | - Zi Qiang Glen Liau
- Department of Orthopaedic Surgery, National University Health System, Level 11, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
| | - Kian Loong Melvin Tan
- Department of Orthopaedic Surgery, National University Health System, Level 11, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
| | - Wei Liang Chua
- Department of Orthopaedic Surgery, National University Health System, Level 11, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
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Mastrokostas PG, Mastrokostas LE, Emara AK, Wellington IJ, Ginalis E, Houten JK, Khalsa AS, Saleh A, Razi AE, Ng MK. GPT-4 as a Source of Patient Information for Anterior Cervical Discectomy and Fusion: A Comparative Analysis Against Google Web Search. Global Spine J 2024:21925682241241241. [PMID: 38513636 DOI: 10.1177/21925682241241241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
Abstract
STUDY DESIGN Comparative study. OBJECTIVES This study aims to compare Google and GPT-4 in terms of (1) question types, (2) response readability, (3) source quality, and (4) numerical response accuracy for the top 10 most frequently asked questions (FAQs) about anterior cervical discectomy and fusion (ACDF). METHODS "Anterior cervical discectomy and fusion" was searched on Google and GPT-4 on December 18, 2023. Top 10 FAQs were classified according to the Rothwell system. Source quality was evaluated using JAMA benchmark criteria and readability was assessed using Flesch Reading Ease and Flesch-Kincaid grade level. Differences in JAMA scores, Flesch-Kincaid grade level, Flesch Reading Ease, and word count between platforms were analyzed using Student's t-tests. Statistical significance was set at the .05 level. RESULTS Frequently asked questions from Google were varied, while GPT-4 focused on technical details and indications/management. GPT-4 showed a higher Flesch-Kincaid grade level (12.96 vs 9.28, P = .003), lower Flesch Reading Ease score (37.07 vs 54.85, P = .005), and higher JAMA scores for source quality (3.333 vs 1.800, P = .016). Numerically, 6 out of 10 responses varied between platforms, with GPT-4 providing broader recovery timelines for ACDF. CONCLUSIONS This study demonstrates GPT-4's ability to elevate patient education by providing high-quality, diverse information tailored to those with advanced literacy levels. As AI technology evolves, refining these tools for accuracy and user-friendliness remains crucial, catering to patients' varying literacy levels and information needs in spine surgery.
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Affiliation(s)
- Paul G Mastrokostas
- College of Medicine, State University of New York (SUNY) Downstate, Brooklyn, NY, USA
| | | | - Ahmed K Emara
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Ian J Wellington
- Department of Orthopaedic Surgery, University of Connecticut, Hartford, CT, USA
| | | | - John K Houten
- Department of Neurosurgery, Mount Sinai School of Medicine, New York, NY, USA
| | - Amrit S Khalsa
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Ahmed Saleh
- Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA
| | - Afshin E Razi
- Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA
| | - Mitchell K Ng
- Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA
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12
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Suresh N, Fritz C, De Ravin E, Rajasekaran K. Modern internet search analytics and thyroidectomy: What are patients asking? World J Otorhinolaryngol Head Neck Surg 2024; 10:49-58. [PMID: 38560040 PMCID: PMC10979046 DOI: 10.1002/wjo2.117] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 05/01/2023] [Indexed: 04/04/2024] Open
Abstract
Objectives Thyroidectomy is among the most commonly performed head and neck surgeries, however, limited existing information is available on topics of interest and concern to patients. Study Design Observational. Setting Online. Methods A search engine optimization tool was utilized to extract metadata on Google-suggested questions that "People Also Ask" (PAA) pertaining to "thyroidectomy" and "thyroid surgery." These questions were categorized by Rothwell criteria and topics of interest. The Journal of the American Medical Association (JAMA) benchmark criteria enabled quality assessment. Results A total of 250 PAA questions were analyzed. Future-oriented PAA questions describing what to expect during and after the surgery on topics such as postoperative management, risks or complications of surgery, and technical details were significantly less popular among the "thyroid surgery" group (P < 0.001, P = 0.005, and P < 0.001, respectively). PAA questions about scarring and hypocalcemia were nearly threefold more popular than those related to pain (335 and 319 vs. 113 combined search engine response page count, respectively). The overall JAMA quality score remained low (2.50 ± 1.07), despite an increasing number of patients searching for "thyroidectomy" (r(77) = 0.30, P = 0.007). Conclusions Patients searching for the nonspecific term "thyroid surgery" received a curated collection of PAA questions that were significantly less likely to educate them on what to expect during and after surgery, as compared to patients with higher health literacy who search with the term "thyroidectomy." This suggests that the content of PAA questions differs based on the presumed health literacy of the internet user.
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Affiliation(s)
- Neeraj Suresh
- Department of Otorhinolaryngology–Head & Neck SurgeryUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Christian Fritz
- Department of Otorhinolaryngology–Head & Neck SurgeryUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Emma De Ravin
- Department of Otorhinolaryngology–Head & Neck SurgeryUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Perelman School of Medicine at the University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Karthik Rajasekaran
- Department of Otorhinolaryngology–Head & Neck SurgeryUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Leonard Davis Institute of Health EconomicsUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
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McCormick JR, Harkin WE, Hodakowski AJ, Streepy JT, Khan ZA, Mowers CC, Urie BR, Jawanda HS, Jackson GR, Chahla J, Garrigues GE, Verma NN. Analysis of patient-directed search content and online resource quality for ulnar collateral ligament injury and surgery. JSES Int 2024; 8:384-388. [PMID: 38464434 PMCID: PMC10920115 DOI: 10.1016/j.jseint.2023.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024] Open
Abstract
Background Patients use the Internet to learn information about injuries, yet online content remains largely unstudied. This study analyzed patient questions posed online regarding ulnar collateral ligament (UCL) tears or UCL surgical management. Methods Three separate search strings about UCL tear and UCL surgery were queried on the Google search engine. The 300 most commonly asked questions were compiled for each topic and associated webpage information was collected from the "People also ask" section. Questions were categorized using the Rothwell classification and webpages by Journal of the American Medical Association (JAMA) benchmark criteria. Results The most frequent UCL tear questions were "how long does it take to heal a torn UCL?" and "what is nonsurgical treatment for the UCL?" The most frequent UCL surgery question was "can you retear your UCL after surgery?" The Rothwell classification of questions for UCL tear/UCL surgery was 55%/32% policy, 38%/57% fact, and 7%/11% value with highest subcategories being indications/management (46%/25%) and technical details (24%/25%). The most common webpages were academic (39%/29%) and medical practice (24%/26%). Mean JAMA score for all 600 webpages was low (1.2), with journals (mean = 3.4) having the highest score. Medical practice (mean = 0.5) and legal websites (mean = 0.0) had the lowest JAMA scores. Only 30% of webpages provided UCL-specific information. Conclusion Online UCL patient questions commonly pertain to technical details and injury management. Webpages suggested by search engines contain information specific to UCL tears and surgery only one-third of the time. The quality of most webpages provided to patients is poor, with minimal source transparency.
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Affiliation(s)
| | - William E. Harkin
- Rush University Medical Center, Department of Orthopedic Surgery, Chicago, IL, USA
| | | | - John T. Streepy
- Rush University Medical Center, Department of Orthopedic Surgery, Chicago, IL, USA
| | - Zeeshan A. Khan
- Rush University Medical Center, Department of Orthopedic Surgery, Chicago, IL, USA
| | - Colton C. Mowers
- Rush University Medical Center, Department of Orthopedic Surgery, Chicago, IL, USA
| | - Braedon R. Urie
- Rush University Medical Center, Department of Orthopedic Surgery, Chicago, IL, USA
| | - Harkirat S. Jawanda
- Rush University Medical Center, Department of Orthopedic Surgery, Chicago, IL, USA
| | - Garrett R. Jackson
- Rush University Medical Center, Department of Orthopedic Surgery, Chicago, IL, USA
| | - Jorge Chahla
- Rush University Medical Center, Department of Orthopedic Surgery, Chicago, IL, USA
| | - Grant E. Garrigues
- Rush University Medical Center, Department of Orthopedic Surgery, Chicago, IL, USA
| | - Nikhil N. Verma
- Rush University Medical Center, Department of Orthopedic Surgery, Chicago, IL, USA
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Wright BM, Bodnar MS, Moore AD, Maseda MC, Kucharik MP, Diaz CC, Schmidt CM, Mir HR. Is ChatGPT a trusted source of information for total hip and knee arthroplasty patients? Bone Jt Open 2024; 5:139-146. [PMID: 38354748 PMCID: PMC10867788 DOI: 10.1302/2633-1462.52.bjo-2023-0113.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
Aims While internet search engines have been the primary information source for patients' questions, artificial intelligence large language models like ChatGPT are trending towards becoming the new primary source. The purpose of this study was to determine if ChatGPT can answer patient questions about total hip (THA) and knee arthroplasty (TKA) with consistent accuracy, comprehensiveness, and easy readability. Methods We posed the 20 most Google-searched questions about THA and TKA, plus ten additional postoperative questions, to ChatGPT. Each question was asked twice to evaluate for consistency in quality. Following each response, we responded with, "Please explain so it is easier to understand," to evaluate ChatGPT's ability to reduce response reading grade level, measured as Flesch-Kincaid Grade Level (FKGL). Five resident physicians rated the 120 responses on 1 to 5 accuracy and comprehensiveness scales. Additionally, they answered a "yes" or "no" question regarding acceptability. Mean scores were calculated for each question, and responses were deemed acceptable if ≥ four raters answered "yes." Results The mean accuracy and comprehensiveness scores were 4.26 (95% confidence interval (CI) 4.19 to 4.33) and 3.79 (95% CI 3.69 to 3.89), respectively. Out of all the responses, 59.2% (71/120; 95% CI 50.0% to 67.7%) were acceptable. ChatGPT was consistent when asked the same question twice, giving no significant difference in accuracy (t = 0.821; p = 0.415), comprehensiveness (t = 1.387; p = 0.171), acceptability (χ2 = 1.832; p = 0.176), and FKGL (t = 0.264; p = 0.793). There was a significantly lower FKGL (t = 2.204; p = 0.029) for easier responses (11.14; 95% CI 10.57 to 11.71) than original responses (12.15; 95% CI 11.45 to 12.85). Conclusion ChatGPT answered THA and TKA patient questions with accuracy comparable to previous reports of websites, with adequate comprehensiveness, but with limited acceptability as the sole information source. ChatGPT has potential for answering patient questions about THA and TKA, but needs improvement.
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Affiliation(s)
- Benjamin M. Wright
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Michael S. Bodnar
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Andrew D. Moore
- Department of Orthopaedic Surgery, University of South Florida, Tampa, Florida, USA
| | - Meghan C. Maseda
- Department of Orthopaedic Surgery, University of South Florida, Tampa, Florida, USA
| | - Michael P. Kucharik
- Department of Orthopaedic Surgery, University of South Florida, Tampa, Florida, USA
| | - Connor C. Diaz
- Department of Orthopaedic Surgery, University of South Florida, Tampa, Florida, USA
| | - Christian M. Schmidt
- Department of Orthopaedic Surgery, University of South Florida, Tampa, Florida, USA
| | - Hassan R. Mir
- Orthopaedic Trauma Service, Florida Orthopedic Institute, Tampa, Florida, USA
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15
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Scuderi GR, Layson JT, Mont MA. The Rise of Social Media in Total Joint Arthroplasty: An Editorial Viewpoint. J Arthroplasty 2024; 39:283-284. [PMID: 37995982 DOI: 10.1016/j.arth.2023.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2023] Open
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16
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Gaudiani MA, Castle JP, Gasparro MA, Halkias EL, Adjemian A, McGee A, Fife J, Moutzouros V, Lynch TS. What Do Patients Encounter When Searching Online About Meniscal Surgery? An Analysis of Internet Trends. Orthop J Sports Med 2024; 12:23259671231219014. [PMID: 38274014 PMCID: PMC10809868 DOI: 10.1177/23259671231219014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 06/29/2023] [Indexed: 01/27/2024] Open
Abstract
Background Many patients use the internet to learn about their orthopaedic conditions and find answers to their common questions. However, the sources and quality of information available to patients regarding meniscal surgery have not been fully evaluated. Purpose To determine the most frequently searched questions associated with meniscal surgery based on question type and topic, as well as to assess the website source type and quality. Study Design Cross-sectional study. Methods The following search terms were entered into a web search (www.google.com) using a clean-install browser: "meniscal tear,""meniscus repair,""meniscectomy,""knee scope,""meniscus surgery," and "knee arthroscopy." The Rothwell classification system was used to categorize questions and sort them into 1 of 13 topics relevant to meniscal surgery. Websites were also categorized by source into groups. The Journal of the American Medical Association (JAMA) benchmark criteria (medians and interquartile ranges [IQRs]) were used to measure website quality. Results A total of 337 unique questions associated with 234 websites were extracted and categorized. The most popular questions were "What is the fastest way to recover from meniscus surgery?" and "What happens if a meniscus tear is left untreated?" Academic websites were associated more commonly with diagnosis questions (41.9%, P < .01). Commercial websites were associated more commonly with cost (71.4%, P = .03) and management (47.6%, P = .02). Government websites addressed a higher proportion of questions regarding timeline of recovery (22.2%, P < .01). Websites associated with medical practices were associated more commonly with risks/complications (43.8%, P = .01) while websites associated with single surgeons were associated more commonly with pain (19.4%, P = .03). Commercial and academic websites had the highest median JAMA benchmark scores (4 [IQR, 3-4] and 3 [IQR, 2-4], respectively) while websites associated with a single surgeon or categorized as "other" had the lowest scores (1 [IQR 1-2] and 1 [IQR 1-1.5], respectively). Conclusion Our study found that the most common questions regarding meniscal surgery were associated with diagnosis of meniscal injury, followed by activities and restrictions after meniscal surgery. Academic websites were associated significantly with diagnosis questions. The highest quality websites were commercial and academic websites.
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Affiliation(s)
| | - Joshua P. Castle
- Department of Orthopedic Surgery, Henry Ford Health, Detroit, Michigan, USA
| | | | | | | | - Anna McGee
- Department of Orthopedic Surgery, Henry Ford Health, Detroit, Michigan, USA
| | - Jonathan Fife
- Department of Orthopedic Surgery, Henry Ford Health, Detroit, Michigan, USA
| | | | - T. Sean Lynch
- Department of Orthopedic Surgery, Henry Ford Health, Detroit, Michigan, USA
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17
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Singh SP, Ramprasad A, Luu A, Zaidi R, Siddiqui Z, Pham T. Health Literacy Analytics of Accessible Patient Resources in Cardiovascular Medicine: What are Patients Wanting to Know? Kans J Med 2023; 16:309-315. [PMID: 38298385 PMCID: PMC10829858 DOI: 10.17161/kjm.vol16.20554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 12/21/2023] [Indexed: 02/02/2024] Open
Abstract
Introduction There remains an increasing utilization of internet-based resources as a first line of medical knowledge. Among patients with cardiovascular disease, these resources often are relied upon for numerous diagnostic and therapeutic modalities. However, the reliability of this information is not fully understood. The aim of this study was to provide a descriptive profile on the literacy quality, readability, and transparency of publicly available educational resources in cardiology. Methods The frequently asked questions and associated online educational articles on common cardiovascular diagnostic and therapeutic interventions were investigated using publicly available data from the Google RankBrain machine learning algorithm after applying inclusion and exclusion criteria. Independent raters evaluated questions for Rothwell's Classification and readability calculations. Results Collectively, 520 questions and articles were evaluated across 13 cardiac interventions, resulting in 3,120 readability scores. The sources of articles were most frequently from academic institutions followed by commercial sources. Most questions were classified as "Fact" at 76.0% (n = 395), and questions regarding "Technical Details" of each intervention were the most common subclassification at 56.3% (n = 293). Conclusions Our data show that patients most often are using online search query programs to seek information regarding specific knowledge of each cardiovascular intervention rather than form an evaluation of the intervention. Additionally, these online patient educational resources continue to not meet grade-level reading recommendations.
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Affiliation(s)
- Som P Singh
- University of Missouri-Kansas City School of Medicine, Kansas City, MO
- University of Texas Health Sciences Center at Houston, Houston, TX
| | - Aarya Ramprasad
- University of Missouri-Kansas City School of Medicine, Kansas City, MO
| | - Anh Luu
- University of Missouri-Kansas City School of Medicine, Kansas City, MO
| | - Rohma Zaidi
- University of Missouri-Kansas City School of Medicine, Kansas City, MO
| | - Zoya Siddiqui
- University of Missouri-Kansas City School of Medicine, Kansas City, MO
| | - Trung Pham
- University of Missouri-Kansas City School of Medicine, Kansas City, MO
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18
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Singh SP, Ramprasad A, Qureshi FM, Baig FA, Qureshi F. A Cross-Sectional Study of Graduate Medical Education in Radiological Fellowships using Accessible Content. Curr Probl Diagn Radiol 2023; 52:528-533. [PMID: 37246039 DOI: 10.1067/j.cpradiol.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 03/16/2023] [Accepted: 05/08/2023] [Indexed: 05/30/2023]
Abstract
Graduate medical education in radiology serves an imperative role in training the next generation of specialists. Given the regularity of virtual interviews, the website of a fellowship programs remains a critical first-line source of information of applicants. The aim of this study is to systematically evaluate 7 radiology fellowship programs utilizing a systematic process. A cross-sectional descriptive 286 graduate medical education fellowship programs in radiology were screened from the Fellowship and Residency Electronic Interactive Database (FREIDA). Extracted data was evaluated for comprehensiveness using 20 content criteria, and a readability score is calculated. The mean comprehensiveness among all fellowship program websites was 55.8% (n = 286), and the average FRE among the program overview sections was 11.9 (n = 214). ANOVA revealed no statistical significance in program website comprehensiveness between radiology fellowships (P = 0.33). The quality of a program's website data continues to serve an important role in an applicant's decision-making. Fellowship programs have improved in their content availability overtime, but content reevaluation needs to be continued for tangible improvement.
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Affiliation(s)
- Som P Singh
- University of Missouri Kansas City School of Medicine, Kansas City, MO..
| | - Aarya Ramprasad
- University of Missouri Kansas City School of Medicine, Kansas City, MO
| | - Fahad M Qureshi
- University of Missouri Kansas City School of Medicine, Kansas City, MO
| | - Farhan A Baig
- University of Missouri Kansas City School of Medicine, Kansas City, MO
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Wu MP, Miller LE, Meyer CD, Feng AL, Richmon JD. Online Searches Related to Total Laryngectomy. Laryngoscope 2023; 133:2971-2976. [PMID: 36883665 DOI: 10.1002/lary.30643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/29/2023] [Accepted: 02/21/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVE To identify the most frequently asked questions regarding "laryngectomy" through an assessment of online search data. METHODS Google Search data based on the search term "laryngectomy" were analyzed using Google Trends and Search Response. The most common People Also Ask (PAA) questions were identified and classified by the concept. Each website linked to its respective PAA question was rated for understandability, ease of reading, and reading grade level. RESULTS Search popularity for the term "laryngectomy" remained stable between 2017 and 2022. The most popular PAA themes were post-laryngectomy speech, laryngectomy comparison to tracheostomy, stoma and stoma care, survival/recurrence, and post-laryngectomy eating. Of the 32 websites linked to the top 50 PAA's, eleven (34%) were at or below an 8th grade reading level. CONCLUSION Post-laryngectomy speech, eating, survival, the stoma, and the difference between laryngectomy and tracheostomy are the most common topics searched online in relation to "laryngectomy." These are important areas for both patient and healthcare provider education. LEVEL OF EVIDENCE N/A Laryngoscope, 133:2971-2976, 2023.
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Affiliation(s)
- Michael P Wu
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Lauren E Miller
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Charles D Meyer
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Allen L Feng
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Jeremy D Richmon
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, U.S.A
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Khalil LS, Castle JP, Akioyamen NO, Corsi MP, Cominos ND, Dubé M, Lynch TS. What are patients asking and reading online? An analysis of online patient searches for rotator cuff repair. J Shoulder Elbow Surg 2023; 32:2245-2255. [PMID: 37263485 DOI: 10.1016/j.jse.2023.04.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 04/09/2023] [Accepted: 04/12/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Patients undergoing rotator cuff surgery often search the internet for information regarding the procedure. One popular source, Google, compiles frequently asked questions and links to websites that may provide answers. This study provides an analysis of the most frequently searched questions associated with rotator cuff surgery. We hypothesize that there will be distinct search patterns associated with online queries about rotator cuff surgery that could provide unique insights into patient concerns. METHODS A set of search terms were entered into Google Web Search using a clean-install Google Chrome browser. Frequently associated questions and their webpages were extracted to a database via a data mining extension. Questions were categorized by topics relevant for rotator cuff arthroscopy. Websites were categorized by source and scored for quality using the JAMA Benchmark Criteria. Pearson's χ2 tests were used to analyze nominal data. Student t tests were performed to compare JAMA Benchmark Scores. RESULTS Of the 595 questions generated from the initial search, 372 unique questions associated with 293 websites were extracted and categorized. The most popular question topics were activities/restrictions (20.7%), pain (18.8%), and indications/management (13.2%). The 2 most common websites searched were academic (35.2%) and medical practice (27.4%). Commercial websites were significantly more likely to be associated with questions about cost (57.1% of all cost questions, P = .01), anatomy/function (62.5%, P = .001), and evaluation of surgery (47.6%, P < .001). Academic websites were more likely to be associated with questions about technical details of surgery (58.1%, P < .001). Medical practice and social media websites were more likely associated with activities/restrictions (48.1%, P < .001, and 15.6%, P < .001, respectively). Government websites were more likely associated with timeline of recovery (12.8%, P = .01). On a scale of 0-4, commercial and academic websites had the highest JAMA scores (3.06 and 2.39, respectively). CONCLUSION Patients seeking information regarding rotator cuff repair primarily use the Google search engine to ask questions regarding postoperative activity and restrictions, followed by pain, indications, and management. Academic websites, which were associated with technical details of surgery, and medical practice websites, which were associated with activities/restrictions, were the 2 most commonly searched resources. These results emphasize the need for orthopedic surgeons to provide detailed and informative instructions to patients undergoing rotator cuff repair, especially in the postoperative setting.
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Affiliation(s)
- Lafi S Khalil
- McLaren Flint Hospital, Department of Orthopaedic Surgery, Flint, MI, USA.
| | - Joshua P Castle
- Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, MI, USA
| | - Noel O Akioyamen
- Department of Orthopaedic Surgery, Montefiore Medical Center, The Bronx, NY, USA
| | | | | | - Michael Dubé
- Northeast Ohio Medical University, Rootstown, OH, USA
| | - T Sean Lynch
- Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, MI, USA
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Smith SR, Hodakowski A, McCormick JR, Spaan J, Streepy J, Mowers C, Simcock X. Patient-Directed Online Education for Carpal Tunnel Syndrome and Release: Analysis of What Patients Ask and Quality of Resources. JOURNAL OF HAND SURGERY GLOBAL ONLINE 2023; 5:818-822. [PMID: 38106941 PMCID: PMC10721500 DOI: 10.1016/j.jhsg.2023.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 07/19/2023] [Indexed: 12/19/2023] Open
Abstract
Purpose This study classifies common questions searched by patients from the Google search engine and categorizes the types and quality of online education resources used by patients regarding carpal tunnel syndrome (CTS) and carpal tunnel release (CTR). Methods Google's results were extracted and compiled using the "People also ask" function for frequent questions and associated web pages for CTS and CTR. Questions were categorized using Rothwell's classification with further topic subcategorization. Web pages were evaluated by using Journal of the American Medical Association Benchmark Criteria for source quality. Results Of the 600 questions evaluated, "How do I know if I have carpal tunnel or tendonitis?" and "What causes carpal tunnel to flare up?" were the most commonly investigated questions for CTS. For CTR, frequent questions investigated included "How long after hand surgery can I drive" and "How do you wipe after carpal tunnel surgery." The most common questions for CTS by Rothwell classification were policy (51%), fact (41%), and value (8%) with the highest subcategories being indications/management (46%) and technical details (27%). For CTR, the most common questions entailed fact (54%), policy (34%), and value (11%) with the highest subcategories as technical details (31%) and indications/management (26%). The most common web pages were academic and medical practice. The mean Journal of the American Medical Association score for all 600 web pages was 1.43, with journals (mean = 3.91) having the highest score and legal (mean = 0.52) and single surgeon practice websites (mean = 0.28) having the lowest scores. Conclusions Patients frequently inquire online about etiology, precipitating factors, diagnostic criteria, and activity restrictions regarding CTS/CTR. Overall, the quality of online resources for this topic was poor, especially from single surgeon practices and legal websites. Clinical relevance Understanding the type and quality of information patients are accessing assists physicians in tailoring counseling to patient concerns and facilitates informed decision-making regarding CTS/CTR as well as guiding patients to high-quality online searches.
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Affiliation(s)
- Shelby R Smith
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL
| | | | | | - Jonathan Spaan
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL
| | - John Streepy
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL
| | - Colton Mowers
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL
| | - Xavier Simcock
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL
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Castle JP, Khalil LS, Tramer JS, Huyke-Hernández FA, Haddad J, Fife J, Esho Y, Gasparro MA, Moutzouros V, Lynch TS. Indications for Surgery, Activities After Surgery, and Pain Are the Most Commonly Asked Questions in Anterior Cruciate Ligament Injury and Reconstruction. Arthrosc Sports Med Rehabil 2023; 5:100805. [PMID: 37753188 PMCID: PMC10518323 DOI: 10.1016/j.asmr.2023.100805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 08/18/2023] [Indexed: 09/28/2023] Open
Abstract
Purpose To leverage Google's search algorithms to summarize the most commonly asked questions regarding anterior cruciate ligament (ACL) injuries and surgery. Methods Six terms related to ACL tear and/or surgery were searched on a clean-installed Google Chrome browser. The list of questions and their associated websites on the Google search page were extracted after multiple search iterations performed in January of 2022. Questions and websites were categorized according to Rothwell's criteria. The Journal of the American Medical Association (JAMA) Benchmark criteria were used to grade website quality and transparency. Descriptive statistics were provided. χ2 and Student t-tests identified for categorical differences and differences in JAMA score, respectively (significance set at P < .05). Results A total of 273 unique questions associated with 204 websites were identified. The most frequently asked questions involved Indications/Management (20.2%), Specific Activities (15.8%), and Pain (10.3%). The most common websites were Medical Practice (27.9%), Academic (23.5%), and Commercial (19.5%). In Academic websites, questions regarding Specific Activities were seldom included (4.7%) whereas questions regarding Pain were frequently addressed (39.3%, P = .027). Although average JAMA score was relatively high for Academic websites, the average combined score for medical and governmental websites was lower (P < .001) than nonmedical websites. Conclusions The most searched questions on Google regarding ACL tears or surgery related to indications for surgery, pain, and activities postoperatively. Health information resources stemmed from Medical Practice (27.9%) followed by Academic (23.5%) and Commercial (19.5%) websites. Medical websites had lower JAMA quality scores compared with nonmedical websites. Clinical Relevance These findings presented may assist physicians in addressing the most frequently searched questions while also guiding their patients to greater-quality resources regarding ACL injuries and surgery.
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Affiliation(s)
- Joshua P. Castle
- Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, U.S.A
| | - Lafi S. Khalil
- Department of Orthopaedic Surgery, McLaren Hospital, Flint, Michigan, U.S.A
| | - Joseph S. Tramer
- Department of Orthopaedic Surgery, Division of Sports Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
| | | | - Jamil Haddad
- Michigan State University College of Osteopathic Medicine, East Lansing, Michigan, U.S.A
| | - Johnathan Fife
- Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, U.S.A
| | - Yousif Esho
- Oakland University William Beaumont School of Medicine, Rochester, Michigan, U.S.A
| | - Matthew A. Gasparro
- Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, U.S.A
| | - Vasilios Moutzouros
- Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, U.S.A
| | - T. Sean Lynch
- Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, U.S.A
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23
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Fotouhi AR, Chiang SN, Said AM, Skolnick GB, Snyder-Warwick AK. What do patients want to know about gender-affirming surgery? Analysis of common patient concerns and online health materials. J Plast Reconstr Aesthet Surg 2023; 85:55-58. [PMID: 37473642 DOI: 10.1016/j.bjps.2023.06.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 05/15/2023] [Accepted: 06/25/2023] [Indexed: 07/22/2023]
Abstract
PURPOSE Patients considering gender-affirming surgery often utilize online health materials to obtain information about procedures. However, the distribution of patient concerns and content of online resources for gender-affirming surgery have not been examined. We aimed to quantify and comprehensively analyze the most searched questions of patients seeking gender-affirming surgery and to examine the quality and readability of associated websites providing the answers. METHODS Questions were extracted from Google using the search phrases "gender-affirming surgery," "transgender surgery," "top surgery," and "bottom surgery." Questions were categorized by topic and average search volume per month was determined. Websites linked to questions were categorized by type, and quality of the health information was evaluated utilizing the DISCERN instrument (16-80). Readability was assessed with the Flesch Reading Ease Score and Flesch-Kincaid Grade Level. RESULTS Ninety questions and associated websites were analyzed. Common questions were most frequently answered by academic websites (30%). Topics included cost (27%), technical details of surgery (23%), and preoperative considerations (11%). Median (interquartile range) DISCERN score across all website categories was 42 (18). The mean readability was of a 12th-grade level, well above the grade six reading level recommended by the American Medical Association. CONCLUSIONS Online gender-affirming surgery materials are difficult to comprehend and of poor quality. To enhance patient knowledge, informed consent, and shared decision-making, there is a substantial need to create understandable and high-quality online health information for those seeking gender-affirming surgery.
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Affiliation(s)
- Annahita R Fotouhi
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Sarah N Chiang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Abdullah M Said
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Gary B Skolnick
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Alison K Snyder-Warwick
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
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Ferrell SC, Ferrell MC, Claassen A, Balogun SA, Vassar M. Frequently asked questions about mobility devices among older adults. Eur Geriatr Med 2023; 14:1075-1081. [PMID: 37505403 DOI: 10.1007/s41999-023-00815-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 06/07/2023] [Indexed: 07/29/2023]
Abstract
PURPOSE To assess frequently asked questions (FAQs) about mobility devices among older adults. MATERIALS AND METHODS We searched multiple terms on Google to find FAQs. Rothwell's classification, JAMA benchmark criteria, and Brief DISCERN were used to categorize and assess each entry. RESULTS Our search yielded 224 unique combinations of questions and linked answer sources. Viewing questions alone resulted in 214 unique FAQs, with the majority seeking factual information (130/214, 60.7%). Viewing website sources alone resulted in 175 unique answer sources, most of which were retail commercial sites (68/175, 38.9%) followed by non-retail commercial sites (65/175, 37.1%). Statistical analysis showed a significant difference between the JAMA benchmark scores by source type (p < 0.00010) and Brief DISCERN scores by source type (p = 0.0001). DISCUSSION Our findings suggest government, academic, and possibly non-retail commercial sources may provide better quality information about the use of mobility devices. We recommend medical providers be prepared to promote and provide quality resources on the risks, benefits, and proper techniques for using mobility devices.
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Affiliation(s)
- Sydney C Ferrell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK, 74107, USA.
| | - Matthew C Ferrell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK, 74107, USA
| | - Analise Claassen
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK, 74107, USA
| | - Seki A Balogun
- Department of the Geriatric Medicine, The University of Oklahoma College of Medicine, Oklahoma City, OK, USA
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK, 74107, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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25
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Fritz C, Barrette LX, Prasad A, Triantafillou V, Suresh N, De Ravin E, Rajasekaran K. Human papillomavirus related oropharyngeal cancer: identifying and quantifying topics of patient interest. J Laryngol Otol 2023; 137:1141-1148. [PMID: 36794539 DOI: 10.1017/s0022215123000270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
OBJECTIVE As the incidence of human papillomavirus related oropharyngeal cancer continues to rise, it is increasingly important for public understanding to keep pace. This study aimed to identify areas of patient interest and concern regarding human papillomavirus and oropharyngeal cancer. METHOD This study was a retrospective survey of search queries containing the keywords 'HPV cancer' between September 2015 and March 2021. RESULTS There was 3.5-fold more interest in human papillomavirus related oropharyngeal cancer (15 800 searches per month) compared with human papillomavirus related cervical cancer (4500 searches per month). Among searches referencing cancer appearance, 96.8 per cent pertained to the head and neck region (3050 searches per month). Among vaccination searches, 16 of 47 (34.0 per cent; 600 searches per month) referenced human papillomavirus vaccines as being a cause of cancer rather than preventing cancer. CONCLUSION The vast majority of online searches into human papillomavirus cancer pertain to the oropharynx. There are relatively few search queries on the topic of vaccination preventing human papillomavirus associated oropharyngeal cancer, which highlights the continued importance of patient education and awareness campaigns.
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Affiliation(s)
- C Fritz
- Department of Otorhinolaryngology - Head & Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - L-X Barrette
- Department of Otorhinolaryngology - Head & Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
| | - A Prasad
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - V Triantafillou
- Department of Otorhinolaryngology - Head & Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - N Suresh
- Department of Otorhinolaryngology - Head & Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - E De Ravin
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - K Rajasekaran
- Department of Otorhinolaryngology - Head & Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
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26
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Varghese KJ, Singh SP, Qureshi FM, Shreekumar S, Ramprasad A, Qureshi F. Digital Patient Education on Xanthelasma Palpebrarum: A Content Analysis. Clin Pract 2023; 13:1207-1214. [PMID: 37887084 PMCID: PMC10605081 DOI: 10.3390/clinpract13050108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023] Open
Abstract
Patient education has been transformed using digital media and online repositories which disseminate information with greater efficiency. In dermatology, this transformation has allowed for patients to gain education on common cutaneous conditions and improve health literacy. Xanthelasma palpebrarum is one of the most common cutaneous conditions, yet there is a poor understanding of how digital materials affect health literacy on this condition. Our study aimed to address this paucity of literature utilizing Brief DISCERN, Rothwell's Classification of Questions, and six readability calculations. The findings of this study indicate a poor-quality profile (Brief DISCERN < 16) regarding digital materials and readability scores which do not meet grade-level recommendations in the United States. This indicates a need to improve the current body of educational materials used by clinicians for diagnosing and managing xanthelasma palpebrarum.
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Affiliation(s)
- Kevin J. Varghese
- Department of Biomedical Sciences, University of Missouri Kansas City School of Medicine, Kansas City, MO 64108, USA; (F.M.Q.); (S.S.); (A.R.)
| | - Som P. Singh
- Department of Biomedical Sciences, University of Missouri Kansas City School of Medicine, Kansas City, MO 64108, USA; (F.M.Q.); (S.S.); (A.R.)
| | - Fahad M. Qureshi
- Department of Biomedical Sciences, University of Missouri Kansas City School of Medicine, Kansas City, MO 64108, USA; (F.M.Q.); (S.S.); (A.R.)
| | - Shreevarsha Shreekumar
- Department of Biomedical Sciences, University of Missouri Kansas City School of Medicine, Kansas City, MO 64108, USA; (F.M.Q.); (S.S.); (A.R.)
| | - Aarya Ramprasad
- Department of Biomedical Sciences, University of Missouri Kansas City School of Medicine, Kansas City, MO 64108, USA; (F.M.Q.); (S.S.); (A.R.)
| | - Fawad Qureshi
- Department of Nephrology, Mayo Clinic Alix School of Medicine, Rochester, MN 55905, USA;
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27
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Dubin J, Sudah SY, Moverman MA, Pagani NR, Puzzitiello RN, Menendez ME, Guss MS. Google Search Analytics for Lateral Epicondylitis. Hand (N Y) 2023:15589447231199799. [PMID: 37746689 DOI: 10.1177/15589447231199799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
BACKGROUND The use of online search engines for health information is becoming common practice. We analyzed Google search queries to identify the most frequently asked topics and questions related to lateral epicondylitis ("tennis elbow") and the Web sites provided to address these questions. METHODS Four search terms for lateral epicondylitis were entered into Google Web Search. A list of the most frequently asked questions along with their associated Web sites was extracted and categorized by 2 independent reviewers. RESULTS A total of 400 questions were extracted with 168 associated Web sites. The most popular question topics were related to indications/management (39.0%), risks/complications (19.5%), and the ability to perform specific activities (18.8%). Frequently asked questions had to do with the duration of symptoms, self-management strategies (eg, brace use and self-massage), and the indications for surgery. The most common Web sites provided to address these questions were social media (27.5%), commercial (24.5%), academic (16.5%), and medical practice (16.3%). CONCLUSION The most frequently asked questions about lateral epicondylitis on Google centered around symptom duration and management, with most information originating from social media and commercial Web sites. Our data can be used to anticipate patient concerns and set expectations regarding the prognosis and management of lateral epicondylitis.
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Affiliation(s)
| | - Suleiman Y Sudah
- Department of Orthopedic Surgery, Monmouth Medical Center, Long Branch, NJ, USA
| | - Michael A Moverman
- Department of Orthopedic Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Nicholas R Pagani
- Department of Orthopedic Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Richard N Puzzitiello
- Department of Orthopedic Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | | | - Michael S Guss
- Department of Orthopaedic Surgery, Hand Surgery, Newton-Wellesley Hospital, Tufts University School of Medicine, Newton, MA, USA
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Yamaguchi S, Kimura S, Watanabe S, Mikami Y, Nakajima H, Yamaguchi Y, Sasho T, Ohtori S. Internet search analysis on the treatment of rheumatoid arthritis: What do people ask and read online? PLoS One 2023; 18:e0285869. [PMID: 37738275 PMCID: PMC10516429 DOI: 10.1371/journal.pone.0285869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 05/02/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVES This study aimed to characterize the content of frequently asked questions about the treatment of rheumatoid arthritis (RA) on the internet in Japan and to evaluate the quality of websites related to the questions. METHODS We searched terms on the treatment of RA on Google and extracted frequently asked questions generated by the Google "people also ask" function. The website that answered each question was also obtained. We categorized the questions based on the content. The quality of the websites was evaluated using the brief DISCERN, Journal of American Medical Association benchmark criteria, and Clear Communication Index. RESULTS Our search yielded 83 questions and the corresponding websites. The most frequently asked questions were regarding the timeline of treatment (n = 17, 23%) and those on the timeline of the clinical course (n = 13, 16%). The median score of brief DISCERN was 11 points, with only 7 (8%) websites having sufficient quality. Websites having sufficient quality based on the Journal of American Medical Association benchmark criteria and Clear Communication Index were absent. CONCLUSIONS The questions were most frequently related to the timeline of treatment and clinical course. Physicians should provide such information to patients with RA in the counseling and education materials.
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Affiliation(s)
- Satoshi Yamaguchi
- Graduate School of Global and Transdisciplinary Studies, Chiba University, Chiba-shi, Chiba, Japan
- Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba-shi, Chiba, Japan
| | - Seiji Kimura
- Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba-shi, Chiba, Japan
| | - Shotaro Watanabe
- Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba-shi, Chiba, Japan
| | - Yukio Mikami
- Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba-shi, Chiba, Japan
| | - Hirofumi Nakajima
- Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba-shi, Chiba, Japan
| | - Yukiko Yamaguchi
- Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba-shi, Chiba, Japan
| | - Takahisa Sasho
- Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba-shi, Chiba, Japan
- Center for Preventive Medical Sciences, Chiba University, Chiba-shi, Chiba, Japan
| | - Seiji Ohtori
- Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba-shi, Chiba, Japan
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Yamamura A, Watanabe S, Yamaguchi S, Iwata K, Kimura S, Mikami Y, Toguchi K, Sakamoto T, Ito R, Nakajima H, Sasho T, Ohtori S. Readability and quality of online patient resources regarding knee osteoarthritis and lumbar spinal stenosis in Japan. J Orthop Sci 2023:S0949-2658(23)00212-9. [PMID: 37599135 DOI: 10.1016/j.jos.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/10/2023] [Accepted: 08/02/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND This study aimed to quantify the readability and quality of online patient resources on knee osteoarthritis and lumbar spinal stenosis in Japan. METHODS Three search engines (Google, Yahoo, and Bing) were searched for the terms knee osteoarthritis and lumbar spinal stenosis. The first 30 websites of each search were screened. Duplicate websites and those unrelated to the searched diseases were excluded. The remaining 125 websites (62 on knee osteoarthritis, 63 on lumbar spinal stenosis) were analyzed. The text readability was assessed using two web-based programs (Obi-3 and Readability Research Lab) and lexical density. Website quality was evaluated using the DISCERN score, Clear Communication Index, and Journal of American Medical Association benchmark criteria. RESULTS Readability scores were high, indicating that the texts were difficult to understand. Only 24 (19%) and six (5%) websites were classified as average difficulty readability according to Obi-3 and Readability Research Lab, respectively. The overall quality of information was low, with only four (3%) being rated as having sufficient quality based on the Clear Communication Index and Journal of American Medical Association benchmark criteria. None of the websites satisfied the DISCERN quality criteria. CONCLUSIONS Patient information on Japanese websites regarding knee osteoarthritis and lumbar spinal stenosis were difficult to understand. Moreover, the quality of the websites was insufficient. Orthopaedic surgeons should contribute to the creation of high-quality easy-to-read websites to facilitate patient-physician communication.
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Affiliation(s)
- Atsushi Yamamura
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan
| | - Shotaro Watanabe
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan
| | - Satoshi Yamaguchi
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan; Graduate School of Global and Transdisciplinary Studies, Chiba University, Chiba, Japan.
| | - Kazunari Iwata
- Department of Japanese Language and Literature, University of the Sacred Heart, Tokyo, Japan
| | - Seji Kimura
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan
| | - Yukio Mikami
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan
| | - Kaoru Toguchi
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan
| | - Takuya Sakamoto
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan
| | - Ryu Ito
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan
| | - Hirofumi Nakajima
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan
| | - Takahisa Sasho
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan; Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Seiji Ohtori
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan
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Phelps CR, Shepard S, Hughes G, Gurule J, Scott J, Raszewski J, Hatic S, Hawkins B, Vassar M. Insights Into Patients Questions Over Bunion Treatments: A Google Study. FOOT & ANKLE ORTHOPAEDICS 2023; 8:24730114231198837. [PMID: 37767008 PMCID: PMC10521286 DOI: 10.1177/24730114231198837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023] Open
Abstract
Background Approximately 1 in 4 adults will develop hallux valgus (HV). Up to 80% of adult Internet users reference online sources for health-related information. Overall, with the high prevalence of HV combined with the numerous treatment options, we believe patients are likely turning to Internet search engines for questions relevant to HV. Using Google's people also ask (PAA) or frequently asked questions (FAQs) feature, we sought to classify these questions, categorize the sources, as well as assess their levels of quality and transparency. Methods On October 9, 2022, we searched Google using these 4 phrases: "hallux valgus treatment," "hallux valgus surgery," "bunion treatment," and "bunion surgery." The FAQs were classified in accordance with the Rothwell Classification schema and each source was categorized. Lastly, transparency and quality of the sources' information were evaluated with the Journal of the American Medical Association's (JAMA) Benchmark tool and Brief DISCERN, respectively. Results Once duplicates and FAQs unrelated to HV were removed, our search returned 299 unique FAQs. The most common question in our sample was related to the evaluation of treatment options (79/299, 26.4%). The most common source type was medical practices (158/299, 52.8%). Nearly two-thirds of the answer sources (184/299; 61.5%) were lacking in transparency. One-way analysis of variance revealed a significant difference in mean Brief DISCERN scores among the 5 source types, F(4) = 54.49 (P < .001), with medical practices averaging the worst score (12.1/30). Conclusion Patients seeking online information concerning treatment options for HV search for questions pertaining to the evaluation of treatment options. The source type encountered most by patients is medical practices; these were found to have both poor transparency and poor quality. Publishing basic information such as the date of publication, authors or reviewers, and references would greatly improve the transparency and quality of online information regarding HV treatment. Level of Evidence Level V, mechanism-based reasoning.
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Affiliation(s)
- Cole R. Phelps
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Samuel Shepard
- Department of Orthopaedic Surgery, Kettering Health Network, Dayton, OH, USA
| | - Griffin Hughes
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Jon Gurule
- Department of Orthopaedic Surgery, Oklahoma State University Medical Center, Tulsa, OK, USA
| | - Jared Scott
- Department of Orthopaedic Surgery, Oklahoma State University Medical Center, Tulsa, OK, USA
| | - Jesse Raszewski
- Department of Orthopaedic Surgery, Kettering Health Network, Dayton, OH, USA
| | - Safet Hatic
- Department of Orthopaedic Surgery, Kettering Health Network, Dayton, OH, USA
| | - Bryan Hawkins
- Department of Orthopaedic Surgery, Oklahoma State University Medical Center, Tulsa, OK, USA
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- Department of Psychiatry and Behavioral Sciences, College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Dubin JA, Bains SS, Chen Z, Hameed D, Nace J, Mont MA, Delanois RE. Using a Google Web Search Analysis to Assess the Utility of ChatGPT in Total Joint Arthroplasty. J Arthroplasty 2023; 38:1195-1202. [PMID: 37040823 DOI: 10.1016/j.arth.2023.04.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/22/2023] [Accepted: 04/03/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Rapid technological advancements have laid the foundations for the use of artificial intelligence in medicine. The promise of machine learning (ML) lies in its potential ability to improve treatment decision making, predict adverse outcomes, and streamline the management of perioperative healthcare. In an increasing consumer-focused health care model, unprecedented access to information may extend to patients using ChatGPT to gain insight into medical questions. The main objective of our study was to replicate a patient's internet search in order to assess the appropriateness of ChatGPT, a novel machine learning tool released in 2022 that provides dialogue responses to queries, in comparison to Google Web Search, the most widely used search engine in the United States today, as a resource for patients for online health information. For the 2 different search engines, we compared i) the most frequently asked questions (FAQs) associated with total knee arthroplasty (TKA) and total hip arthroplasty (THA) by question type and topic; ii) the answers to the most frequently asked questions; as well as iii) the FAQs yielding a numerical response. METHODS A Google web search was performed with the following search terms: "total knee replacement" and "total hip replacement." These terms were individually entered and the first 10 FAQs were extracted along with the source of the associated website for each question. The following statements were inputted into ChatGPT: 1) "Perform a google search with the search term 'total knee replacement' and record the 10 most FAQs related to the search term" as well as 2) "Perform a google search with the search term 'total hip replacement' and record the 10 most FAQs related to the search term." A Google web search was repeated with the same search terms to identify the first 10 FAQs that included a numerical response for both "total knee replacement" and "total hip replacement." These questions were then inputted into ChatGPT and the questions and answers were recorded. RESULTS There were 5 of 20 (25%) questions that were similar when performing a Google web search and a search of ChatGPT for all search terms. Of the 20 questions asked for the Google Web Search, 13 of 20 were provided by commercial websites. For ChatGPT, 15 of 20 (75%) questions were answered by government websites, with the most frequent one being PubMed. In terms of numerical questions, 11 of 20 (55%) of the most FAQs provided different responses between a Google web search and ChatGPT. CONCLUSION A comparison of the FAQs by a Google web search with attempted replication by ChatGPT revealed heterogenous questions and responses for open and discrete questions. ChatGPT should remain a trending use as a potential resource to patients that needs further corroboration until its ability to provide credible information is verified and concordant with the goals of the physician and the patient alike.
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Affiliation(s)
- Jeremy A Dubin
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland
| | - Sandeep S Bains
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland
| | - Zhongming Chen
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland
| | - Daniel Hameed
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland
| | - James Nace
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland
| | - Michael A Mont
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland
| | - Ronald E Delanois
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland
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Fritz CG, Choi JS, Conway RM, Casale GG, Bojrab DI, Babu SC. Characterizing the most Popular Tinnitus Inquiries: Is Tinnitus Incidence on the Rise Since COVID-19? Otol Neurotol 2023; 44:e435-e442. [PMID: 37205864 PMCID: PMC10289074 DOI: 10.1097/mao.0000000000003902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
OBJECTIVE Approximately 50 million US adults experience chronic tinnitus, yet search behaviors and topics of concern to these patients have not been investigated on a national level. STUDY DESIGN Observational. SETTING Online database and tertiary otology clinic. PATIENTS Nationwide and institutional samples. INTERVENTIONS None. MAIN OUTCOME MEASURE A search engine optimization tool was utilized to extract metadata on "People Also Ask" (PAA) questions pertaining to tinnitus. Website quality was assessed using JAMA benchmark criteria. Search volume trends were investigated along with institutional-level data on tinnitus incidence. RESULTS Of the 500 PAA questions assessed, the majority (54.0%) contained value-type content. The most popular question categories pertained to tinnitus treatment (29.3%), alternative treatment approaches (21.5%), technical details (16.9%), and timeline of symptoms (13.4%). Patients were most interested in treatment with wearable masking devices and most commonly searched for tinnitus as being attributable to a neurologic etiology. Online searches pertaining to unilateral tinnitus symptoms have increased >3-fold since the onset of the COVID-19 pandemic. Likewise, review of patient encounters at our tertiary otology clinic revealed a nearly 2-fold increase in tinnitus consultations since 2020. CONCLUSIONS Topics of interest and concern identified herein may inform the development of patient education materials and help guide clinical practice. Online search data suggest an increase in tinnitus searches since the onset of COVID-19, which did correlate clinically with an increase in tinnitus consultations at our institution.
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Affiliation(s)
- Christian G. Fritz
- Department of Otorhinolaryngology–Head & Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
- Michigan Ear Institute, Farmington Hills, Michigan
| | | | - Robert M. Conway
- Michigan Ear Institute, Farmington Hills, Michigan
- Department of Otolaryngology, Head and Neck Surgery, Ascension Macomb-Oakland Hospital, Madison Heights, Michigan
| | | | - Dennis I. Bojrab
- Michigan Ear Institute, Farmington Hills, Michigan
- Neurotology Division, St John Providence Health System, Novi, Michigan
| | - Seilesh C. Babu
- Michigan Ear Institute, Farmington Hills, Michigan
- Department of Otolaryngology, Head and Neck Surgery, Ascension Macomb-Oakland Hospital, Madison Heights, Michigan
- Neurotology Division, St John Providence Health System, Novi, Michigan
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University, Detroit, Michigan
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Kasthuri V, Homer A, Alsoof D, Hong J, McDonald CL, Diebo BG, Daniels AH. Modern internet search analytics and spine: what are patients asking and reading online? NORTH AMERICAN SPINE SOCIETY JOURNAL 2023; 14:100214. [PMID: 37214263 PMCID: PMC10192655 DOI: 10.1016/j.xnsj.2023.100214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 05/24/2023]
Abstract
Background Google's People Also Ask feature uses various machine learning algorithms to distill the most frequently asked questions and link users to potential answers. The aim of this study is to investigate the most frequently asked questions related to commonly performed spine surgeries. Methods This is an observational study utilizing Google's People Also Ask feature. A variety of search terms were entered into Google for anterior cervical discectomy and fusion (ACDF), discectomy, and lumbar fusion. Frequently asked questions and linked websites were extracted. Questions were categorized by topic based on Rothwell's Classification system, and websites were categorized by type. Pearson's chi-squared and Student t tests were performed as appropriate. Results A total of 576 unique questions (181 ACDF, 148 discectomy, 309 lumbar fusion) were extracted with 372 unique websites and 177 domains. The most common website types were medical practice (41%), social media (22%), and academic (15%). The most popular question topics were specific activities & restrictions (22%), technical details (23%), and evaluation of surgery (17%). Questions related to technical details were more common in discectomy vs lumbar fusion (33% vs 24%, p=.03) and lumbar fusion vs ACDF (24% vs 14%, p=.01). Questions related to specific activities & restrictions were more common in ACDF vs discectomy (17% vs 8%, p=.02) and ACDF vs lumbar fusion (28% vs 19%, p=.016). Questions related to risks & complications were more common in ACDF vs lumbar fusion (10% vs 4%, p=.01). Conclusions The most frequently asked questions on Google regarding spine surgery are related to technical details and activity restrictions. Surgeons may emphasize these domains in consultations and direct patients to reputable sources of further information. Much of the linked information provided originates from nonacademic and nongovernment sources (72%), with 22% from social media websites.
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Affiliation(s)
- Viknesh Kasthuri
- Warren Alpert Medical School, Brown University, 1 Kettle Point Ave, East Providence, RI, 02914, United States
| | - Alexander Homer
- Warren Alpert Medical School, Brown University, 1 Kettle Point Ave, East Providence, RI, 02914, United States
| | - Daniel Alsoof
- Department of Orthopedics, Warren Alpert Medical School, Brown University, 1 Kettle Point Ave, East Providence, RI, 02914, United States
| | - James Hong
- Department of Orthopedics, Warren Alpert Medical School, Brown University, 1 Kettle Point Ave, East Providence, RI, 02914, United States
| | - Christopher L McDonald
- Department of Orthopedics, Warren Alpert Medical School, Brown University, 1 Kettle Point Ave, East Providence, RI, 02914, United States
| | - Bassel G Diebo
- Department of Orthopedics, Warren Alpert Medical School, Brown University, 1 Kettle Point Ave, East Providence, RI, 02914, United States
| | - Alan H Daniels
- Department of Orthopedics, Warren Alpert Medical School, Brown University, 1 Kettle Point Ave, East Providence, RI, 02914, United States
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Fritz C, Ravin ED, Suresh N, Lowery AS, Rajasekaran K. Rhytidectomy-Information Patients Seek and Where They Find Answers. Facial Plast Surg 2023; 39:201-209. [PMID: 36174657 DOI: 10.1055/a-1952-8569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
Patients considering rhytidectomy often search for information online prior to in-office consultation. This study identifies the most searched queries regarding rhytidectomy and evaluates sources to which patients are directed. The search engine optimization tool Ahrefs was utilized to extract Google metadata on searches performed in the United States. Frequently asked questions were categorized by topic; websites were categorized by type. Journal of the American Medical Association (JAMA) benchmark criteria enabled information quality assessment. A total of 565 questions for three search phrases were extracted (265 "facelift," 265 "face lift," and 35 "rhytidectomy"). The majority of monthly searches in the facelift and face lift groups pertained to procedural cost, which was significantly higher than in the rhytidectomy group (52.9% and 50.7 vs. 0.0%, ANOVA p <0.001). The mean JAMA score for private practice sources (1.2 ± 0.42) was significantly lower than that of academic pages of (2.3 ± 1.9, p = 0.026) and commercial sources (3.0 ± 0.82, p = 0.008). The most popular destinations for rhytidectomy were California and Mexico (630 and 440 searches/month). Online searches for facelifts often revolve around the topic of cost and frequently direct patients to websites that provide inadequate information on authorship, attribution, disclosure, and currency.
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Affiliation(s)
- Christian Fritz
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Emma De Ravin
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Neeraj Suresh
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anne S Lowery
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Karthik Rajasekaran
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
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Hodakowski AJ, McCormick JR, Damodar D, Cohn MR, Carey KD, Verma NN, Nicholson G, Garrigues GE. Rotator cuff repair: what questions are patients asking online and where are they getting their answers? Clin Shoulder Elb 2023; 26:25-31. [PMID: 36919504 PMCID: PMC10030981 DOI: 10.5397/cise.2022.01235] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/30/2022] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND This study analyzed questions searched by rotator cuff patients and determined types and quality of websites providing information. METHODS Three strings related to rotator cuff repair were explored by Google Search. Result pages were collected under the "People also ask" function for frequent questions and associated webpages. Questions were categorized using Rothwell classification and topical subcategorization. Webpages were evaluated by Journal of the American Medical Association (JAMA) benchmark criteria for source quality. RESULTS One hundred twenty "People also ask" questions were collected with associated webpages. Using the Rothwell classification of questions, queries were organized into fact (41.7%), value (31.7%), and policy (26.7%). The most common webpage categories were academic (28.3%) and medical practice (27.5%). The most common question subcategories were timeline of recovery (21.7%), indications/ management (21.7%), and pain (18.3%). Average JAMA score for all 120 webpages was 1.50. Journal articles had the highest average JAMA score (3.77), while commercial websites had the lowest JAMA score (0.91). The most commonly suggested question for rotator cuff repair/ surgery was, "Is rotator cuff surgery worth having?," while the most commonly suggested question for rotator cuff repair pain was, "What happens if a rotator cuff is not repaired?" CONCLUSIONS The most commonly asked questions pertaining to rotator cuff repair evaluate management options and relate to timeline of recovery and pain management. Most information is provided by medical practice, academic, and medical information websites, which have highly variable reliability. By understanding questions their patients search online, surgeons can tailor preoperative education to patient concerns and improve postoperative outcomes.
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Affiliation(s)
| | | | - Dhanur Damodar
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Matthew R Cohn
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Kyle D Carey
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Nikhil N Verma
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Gregory Nicholson
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Grant E Garrigues
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
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McCormick JR, Kruchten MC, Mehta N, Damodar D, Horner NS, Carey KD, Nicholson GP, Verma NN, Garrigues GE. Internet search analytics for shoulder arthroplasty: what questions are patients asking? Clin Shoulder Elb 2023; 26:55-63. [PMID: 36919508 PMCID: PMC10030990 DOI: 10.5397/cise.2022.01347] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/02/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Common questions about shoulder arthroplasty (SA) searched online by patients and the quality of this content are unknown. The purpose of this study is to uncover questions SA patients search online and determine types and quality of webpages encountered. METHODS The "People also ask" section of Google Search was queried to return 900 questions and associated webpages for general, anatomic, and reverse SA. Questions and webpages were categorized using the Rothwell classification of questions and assessed for quality using the Journal of the American Medical Association (JAMA) benchmark criteria. RESULTS According to Rothwell classification, the composition of questions was fact (54.0%), value (24.7%), and policy (21.3%). The most common webpage categories were medical practice (24.6%), academic (23.2%), and medical information sites (14.4%). Journal articles represented 8.9% of results. The average JAMA score for all webpages was 1.69. Journals had the highest average JAMA score (3.91), while medical practice sites had the lowest (0.89). The most common question was, "How long does it take to recover from shoulder replacement?" CONCLUSIONS The most common questions SA patients ask online involve specific postoperative activities and the timeline of recovery. Most information is from low-quality, non-peer-reviewed websites, highlighting the need for improvement in online resources. By understanding the questions patients are asking online, surgeons can tailor preoperative education to common patient concerns and improve postoperative outcomes.
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Affiliation(s)
| | - Matthew C Kruchten
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Nabil Mehta
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Dhanur Damodar
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Nolan S Horner
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Kyle D Carey
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Gregory P Nicholson
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Nikhil N Verma
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Grant E Garrigues
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
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Foster BK, Brule NR, Callahan C, Baylor J, Klena JC, Grandizio LC. Online Information Related to Symptoms of Carpal Tunnel Syndrome: A Google Search Analysis. Cureus 2023; 15:e35586. [PMID: 37007327 PMCID: PMC10062431 DOI: 10.7759/cureus.35586] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction While Google is frequently used to access internet-based health resources, the quality of online health information remains variable. Our purpose was to assess suggested resources identified through Google search features for common symptoms related to carpal tunnel syndrome (CTS). Methods Two searches were performed. The first, labeled "symptom-related," included the terms "hand numbness," "hand tingling," and "hand falling asleep." The second, labeled "CTS-specific," included "carpal tunnel syndrome," "carpal tunnel surgery," and "carpal tunnel release." A novel feature of Google's search engine is to display similar searches made by other users ("People Also Ask" snippet). For each search, the first 100 results snippets and the associated website links were recorded. A list of unique questions was compiled and classified into 1 of 3 categories using the Rothwell classification: fact, policy, or value. Questions were also classified based on the diagnoses suggested by the query. Website authorship was determined, and the corresponding links were categorized by two independent reviewers. Results The "symptom-related" searches yielded 175 unique questions and 130 unique website links, and the "CTS-specific" searches yielded a total of 243 questions and 179 unique links. For "symptom-related" searches, 65% of questions suggested a diagnosis, with CTS being suggested as a diagnosis for only 3% of questions. In contrast, CTS was suggested by 92% of questions in "CTS-specific" searches. In both searches, nearly 75% of questions were classified as "facts." Commercial websites were the most common in both searches. Conclusion Google searches for common symptoms of median nerve compression rarely yield information related to CTS.
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Mohamed H, O’Malley L, Kelly D. An infodemiology study on exploring the quality and reliability of colorectal cancer immunotherapy information. Digit Health 2023; 9:20552076231205286. [PMID: 37808242 PMCID: PMC10552482 DOI: 10.1177/20552076231205286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 09/18/2023] [Indexed: 10/10/2023] Open
Abstract
Background Immunotherapy is a new treatment modality which promises hope for advanced colorectal cancer patients. To our knowledge, no previous studies have evaluated the quality of patient information available on this topic online. Objective This study will explore the quality and reliability of colorectal cancer immunotherapy information using the Journal of the American Medical Association (JAMA) and DISCERN tools. Methods Design thinking methodology was integrated with systematic scoping reviews framework to inform our descriptive observational media analysis study. Google Chrome was used to run four searches using prespecified search terms selected according to the top patient concerns about immunotherapy. The first 20 relevant results were identified (n = 80) and then duplicates were removed. Descriptive narrative univariate and bivariate analysis was done for the relevant variables. Results The total of included websites was 17. Most websites score <3 points on JAMA and fair/poor on DISCERN. Most of the websites that score ≥3 points on JAMA and excellent/good on DISCERN have a charity affiliation. A total of 58.8% of the websites present the date, 41.2% demonstrate authorship, and sources are mentioned in 29.4% of the websites. Lack of content was noticed in providing the prognosis of patients if no treatment is given, clear aim and the effect of treatments on patient's quality of life. Conclusion Assessing the reliability of information about cancer treatments online remains a challenge. Further research is required to understand the patient perceptions and use of online information and whether it has an impact on their behavioural health outcomes.
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Affiliation(s)
- Hind Mohamed
- Master of Public Health Programme, School of Medicine, University of Limerick, Limerick, Ireland
| | - Laura O’Malley
- Master of Public Health Programme, School of Medicine, University of Limerick, Limerick, Ireland
| | - Dervla Kelly
- Master of Public Health Programme, School of Medicine, University of Limerick, Limerick, Ireland
- ULCaN and HIST research clusters, Health Research Institute, University of limerick, Limerick, Ireland
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McCormick JR, Kerzner B, Tuthill TA, Khan ZA, Hodakowski AJ, Damodar D, Fortier LM, Dasari SP, Nho SJ, Chahla J. Patients With Femoroacetabular Impingement Obtain Information From Low-Quality Sources Online and Are Most Interested in Conservative Treatment and Expected Recovery. Arthrosc Sports Med Rehabil 2022; 5:e21-e27. [PMID: 36866316 PMCID: PMC9971908 DOI: 10.1016/j.asmr.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 09/28/2022] [Indexed: 12/23/2022] Open
Abstract
Purpose To investigate the type of questions patients undergoing hip arthroscopy for femoroacetabular impingement (FAI) are searching online and determine the type and quality of the online sources from the top results to each query by the "people also ask" Google algorithm. Methods Three search strings pertaining to FAI were carried out through Google. The webpage information was manually collected from the "People also ask" Google algorithm. Questions were categorized using Rothwell's classification method. Each website was assessed using Journal of the American Medical Association Benchmark Criteria for source quality. Results A total of 286 unique questions were collected with their associated webpages. The most common questions included: "How do you treat femoroacetabular impingement and labral tears without surgery?" "What is the recovery process after hip arthroscopy and are there limitations after surgery?" and "How do you diagnose hip impingement and differentiate from other causes of hip pain?" The Rothwell Classification of questions were fact (43.4%), policy (34.3%), and value (20.6%). The most common webpage categories were Medical Practice (30.4%), Academic (25.8%), and Commercial (20.6%). The most common subcategories were Indications/Management (29.7%) and Pain (13.6%). Government websites had the highest average Journal of the American Medical Association score (3.42), whereas Single Surgeon Practice websites had the lowest (1.35). Conclusions: Commonly asked questions on Google regarding FAI and labral tears pertain to the indications and management of pathology as well as pain control and restrictions in activity. The majority of information is provided by medical practice, academic, and commercial sources, which have highly variable academic transparency. Clinical Relevance By better understanding which questions patients ask online, surgeons can personalize patient education and enhance patient satisfaction and treatment outcomes after hip arthroscopy.
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Affiliation(s)
- Johnathon R. McCormick
- Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Benjamin Kerzner
- Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Trevor A. Tuthill
- Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Zeeshan A. Khan
- Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Alexander J. Hodakowski
- Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Dhanur Damodar
- Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Luc M. Fortier
- Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Suhas P. Dasari
- Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Shane J. Nho
- Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Jorge Chahla
- Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
- Address correspondence to Jorge Chahla, M.D., Ph.D., Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W Harrison St., Suite 300, Chicago, IL 60612.
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Sullivan B, Platt B, Joiner J, Jacobs C, Conley C, Landy DC, Stone AV. An Investigation of Google Searches for Knee Osteoarthritis and Stem Cell Therapy: What are Patients Searching Online? HSS J 2022; 18:485-489. [PMID: 36263281 PMCID: PMC9527551 DOI: 10.1177/15563316221089930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 01/07/2022] [Indexed: 02/07/2023]
Abstract
Background Stem cell therapies have emerged as a potential treatment for osteoarthritis (OA), but their role remains controversial. Their growing popularity may lead patients to search for information online, but search queries and sources are unknown. Purpose We sought to (1) identify the most frequently asked questions on Google related to knee OA and stem cell therapy, (2) assess the types of websites accessed through these searches, and (3) evaluate the transparency of these websites. Methods The search terms "knee," "osteoarthritis," and "stem cell" were entered into Google. Frequently asked questions suggested by Google, and their corresponding websites were extracted. Questions and websites were classified by type. Journal of the American Medical Association (JAMA) benchmark criteria were used as a measure of website transparency (range: 0-4). Analysis of variance tests were performed to compare JAMA benchmark criteria between website types. Results Of the 145 questions and website extracted, the most common question subtype pertained to non-stem cell treatments (41.4%) for knee OA; the most common website types were medical publishers (24.8%) and nonacademic medical practices (22.8%). JAMA scores were highest for medical publishers (mean: 3.81) and lowest for nonacademic medical practices (mean: 1.55). Nonacademic medical practices had significantly worse JAMA scores compared with commercial, academic, and medical publishers. Conclusion The most frequent questions pertained to non-stem cell treatments, although questions related to stem cell efficacy were most common among the 10 most frequent questions. Google searches on knee OA and stem cell therapies often directed the user to websites lacking transparency and verifiable information. Further research is warranted.
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Affiliation(s)
- Breanna Sullivan
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY, USA
| | - Brooks Platt
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY, USA
| | - Josh Joiner
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY, USA
| | - Cale Jacobs
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY, USA
| | - Caitlin Conley
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY, USA
| | - David C. Landy
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY, USA
| | - Austin V. Stone
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY, USA
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Sullivan B, Abed V, Joiner J, Benningfield M, Landy D, Hawk GS, Conley C, Jacobs C, Stone AV. The Quality of Online Information for the Treatment of Knee Osteoarthritis: A Google Study. Cureus 2022; 14:e29995. [PMID: 36381839 PMCID: PMC9636897 DOI: 10.7759/cureus.29995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction Affecting more than 30 million adults annually, osteoarthritis (OA) is the most common joint disorder in the United States. A variety of management options for knee OA exists, including physical therapy, weight loss, intra-articular corticosteroid injections, and total joint arthroplasty. With many treatments available, patients often utilize the internet to educate themselves about their condition and management options. The purpose of this study was to evaluate the quality, transparency, and readability of online information for the treatment of knee OA. Methods The search terms “knee,” “arthritis,” and “treatment” were entered into an incognito mode Google browser. Websites were classified by type (commercial, academic, nonacademic medical practice, government/patient advocacy, and other) and graded on content quality, transparency, and readability using the following scores, respectively: modified DISCERN, Journal of American Medical Association (JAMA) Benchmark, and Flesch-Kincaid (FK) grade level. Results Of the 95 websites evaluated, commercial (mean, 38.2) and academic (37.3) sites had the highest total DISCERN scores, which were significantly greater than nonacademic medical practice (31.8) and government/patient advocacy sites (33.4) (p≤0.035). Nonacademic medical practice sites had the lowest mean total DISCERN (31.8) and JAMA (1.47) scores and the highest FK grade level readability (9.5). There was a significant positive correlation between mean total DISCERN and JAMA scores (r=0.46, p<0.001). Conclusion The mean overall quality of websites regarding the treatment of OA was good as evidenced by greater modified DISCERN scores. However, website quality ranged from poor to excellent, indicating that some websites are still missing key information patients may find useful when assessing treatment options online.
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Miltenberg B, Masood R, Katsiaunis A, Moverman MA, Puzzitiello RN, Pagani NR, Menendez ME, Salzler MJ, Drager J. Fracture dislocations of the proximal humerus treated with open reduction and internal fixation: a systematic review. J Shoulder Elbow Surg 2022; 31:e480-e489. [PMID: 35605847 DOI: 10.1016/j.jse.2022.04.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/11/2022] [Accepted: 04/18/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND The treatment of proximal humerus fracture dislocations can be challenging given the extensive injury to the proximal humeral anatomy and increased risk of devascularization of the humeral head often seen in these injuries. The purpose of this study is to undertake a systematic review of the literature on the functional outcomes, rate of revision, and short- and long-term complications for proximal humerus fracture dislocations treated with open reduction and internal fixation (ORIF). METHODS The PubMed and OVID Embase databases were queried for literature reporting on proximal humerus fracture dislocations treated with ORIF. Data including study design, patient demographics, functional outcomes, and complications were recorded. RESULTS Twelve studies including 294 patients with Neer type 2-, 3-, or 4-part proximal humerus fracture dislocations met the criteria for inclusion. The mean patient age was 53.4 years (19-89 years) with an average follow-up of 2.9 years (1.15-4.9 years). At the final follow-up, the mean Constant score was 73.2 (52-87.3) and the mean Disabilities of the Arm Shoulder and Hand score was 26.6 (17.5-32). Avascular necrosis was observed in 20.0% (0%-82.3%) and nonunion was observed in 3.0% (0%-7.7%) of patients. Conversion to arthroplasty was observed in 10.7% (5%-20%) and a total reoperation was observed in 35.6% (11.8%-89.1%) of patients in studies explicitly reporting these outcomes. In addition to conversion to arthroplasty, common causes of reoperation were revision ORIF (5.2%) and hardware removal (22.2%). CONCLUSION Patients undergoing ORIF for proximal humerus fracture dislocations have reasonable functional outcomes but relatively high avascular necrosis and reoperation rates. This information can be used to counsel patients and set expectations about the potential for further surgeries.
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Affiliation(s)
| | - Raisa Masood
- Department of Orthopedic Surgery, Tufts Medical Center, Boston, MA, USA
| | | | | | | | - Nicholas R Pagani
- Department of Orthopedic Surgery, Tufts Medical Center, Boston, MA, USA
| | - Mariano E Menendez
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Matthew J Salzler
- Department of Orthopedic Surgery, Tufts Medical Center, Boston, MA, USA
| | - Justin Drager
- Department of Orthopedic Surgery, Tufts Medical Center, Boston, MA, USA.
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Sajjadi NB, Ottwell R, Shepard S, Bray N, Dyer R, Wilson J, Vassar M, Hartwell M. Assessing the United States' most frequently asked questions about osteopathic medicine, osteopathic education, and osteopathic manipulative treatment. J Osteopath Med 2022; 122:219-227. [PMID: 35179005 DOI: 10.1515/jom-2021-0281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/15/2021] [Indexed: 11/15/2022]
Abstract
CONTEXT Osteopathic medicine in the United States continues to produce a substantial number of physicians and medical educators. However, recently popularized misconceptions about osteopathic medical practice, education, and manual therapy suggest an unsettling prevalence of inaccurate beliefs held by the public. The public often searches the internet to find out information about osteopathic medicine, but the content of questions and the transparency of the resulting information is unknown. OBJECTIVES We sought to explore frequently asked questions (FAQs) generated by Google to assess commonly searched questions about the osteopathic profession and to determine the level of information transparency associated with resulting sources. METHODS On June 16, 2021, we searched Google for three terms: "osteopathic medicine," "doctor of osteopathic medicine," and "DO," until a minimum of 100 FAQs and their answer links were extracted from each search. After excluding irrelevant FAQs, we used Rothwell's Classification of Questions to categorize the FAQs. We then used the Journal of the American Medical Association's Benchmark Criteria to assess information transparency for each corresponding answer source provided by Google. The answer sources were screened for the inappropriate use of "osteopathy" in place of "osteopathic medicine" and for "osteopath" in place of "DO," "Doctor of Osteopathic Medicine," or "Osteopathic Physician." We performed statistical tests to ascertain the differences in information transparency between osteopathic and nonosteopathic information sources. RESULTS Our Google search revealed 110 unique FAQs about osteopathic medicine. The majority of FAQs were classified as fact-based (82/110; 74.55%), nearly half of which (45.12%) were related to the medical practicing privileges of DOs. The FAQs were most commonly answered by academic institutions (44/110, 40.0%). Nearly half (49.09%) of the linked answer sources were deemed inadequate by JAMA benchmark criteria. Of the 110 linked answer sources, 19 (17.27%) misused either osteopathy, osteopath, or both to describe osteopathic physicians. Only 30 sources were linked to US-based osteopathic organizations. Osteopathic organizations were statistically less likely to meet high-transparency criteria than nonosteopathic organizations (p=0.002). CONCLUSIONS Our study shows that the US public may be unsure about the physician status of DOs, which may prevent securing the professional identity of osteopathic physicians in the eyes of the public. Osteopathic organizations should tailor awareness campaigns toward addressing the common misconceptions revealed by our study. Osteopathic organizations should use transparency criteria as a rubric when publishing information to enhance transparency.
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Affiliation(s)
- Nicholas B Sajjadi
- Office of Medical Student Research, College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Ryan Ottwell
- Office of Medical Student Research, College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Samuel Shepard
- Office of Medical Student Research, College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Natasha Bray
- Office of Medical Student Research, College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA.,Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Robin Dyer
- Office of Medical Student Research, College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA.,Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Jennifer Wilson
- Office of Medical Student Research, College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA.,Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Matt Vassar
- Office of Medical Student Research, College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA.,Department of Psychiatry and Behavioral Sciences, College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Micah Hartwell
- Office of Medical Student Research, College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA.,Department of Psychiatry and Behavioral Sciences, College of Osteopathic Medicine, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Fassas SN, Peterson AM, Farrokhian N, Zonner JG, Cummings EL, Arambula Z, Chiu AG, Goyal Fox M. Sinus Surgery and Balloon Sinuplasty: What Do Patients Want to Know? Otolaryngol Head Neck Surg 2022; 167:777-784. [PMID: 35133898 DOI: 10.1177/01945998221076803] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Limited knowledge exists regarding the information patients seek online about sinus procedures. The goals of our study were to identify the most searched online queries regarding functional endoscopic sinus surgery (FESS) and balloon sinuplasty and evaluate the sources to which patients are directed. STUDY DESIGN Observational. SETTING Online Google Database. METHODS Google data were analyzed using the search engine optimization tool Ahrefs. People Also Ask (PAA) questions (extracted from Google searches) helped identify questions for analysis of search query volume. Search results were categorized into specific topics, and the source (eg, academic vs medical practice) of the information was identified. The JAMA benchmark criteria were used to determine the quality of the online resource. RESULTS The most searched term (average monthly queries) on Google was "sinus surgery" (13,190), followed by "balloon sinuplasty" (9212). For FESS and balloon sinuplasty, most questions focused on treatment of sinusitis (71.64% vs 79.19%) and preoperative inquiries about sinus issues (11.50% vs 11.35%). Answers to PAA questions for FESS were obtained from academic sources at a higher frequency compared to balloon sinuplasty (26.7% vs 10.3%, P = .016) but a lower frequency from medical practice websites (15.2% vs 29.3%, P = .042). The mean (SD) JAMA scores for FESS and balloon sinuplasty sources were 1.59 (1.46) and 1.40 (1.46), respectively. CONCLUSION There is a high volume of online search queries regarding FESS and balloon sinuplasty. The quality of the sources could be improved by addressing authorship, attribution, disclosure, and currency. This information may help otolaryngologists better address patient queries.
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Affiliation(s)
- Scott N Fassas
- Department of Otolaryngology-Head & Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Andrew M Peterson
- University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Nathan Farrokhian
- Department of Otolaryngology-Head & Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Jordan G Zonner
- Department of Otolaryngology-Head & Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Emily L Cummings
- Department of Otolaryngology-Head & Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Zachary Arambula
- Department of Otolaryngology-Head & Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Alexander G Chiu
- Department of Otolaryngology-Head & Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Meha Goyal Fox
- Department of Otolaryngology-Head & Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
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Fassas SN, Krane NA, Zonner JG, Sykes KJ, Kriet JD, Humphrey CD. Google Search Analysis: What Do People Want to Know About Rhinoplasty and Where Do They Find the Answers? Facial Plast Surg Aesthet Med 2021; 24:363-368. [PMID: 34591713 DOI: 10.1089/fpsam.2021.0100] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: During online search queries, Google uses machine learning algorithms to provide frequently associated ("People Also Ask" [PAA]) questions with corresponding websites answering the question. We aimed to identify the most frequent questions about rhinoplasty asked online and the sources used to answer them. Materials and Methods: PAA questions were extracted for the terms "rhinoplasty," "nose surgery," and "nose job." Questions were categorized into specific topics. Websites were categorized by type and assessed for quality using Journal of the American Medical Association (JAMA) benchmark criteria. A search engine optimization tool determined search volume for individual questions and specific topics. Results: Internet searches for the PAA questions (n = 102) and associated websites were related to preoperative factors (46%), cost (35.7%), and recovery timeline (7.3%). Sources for the answers to PAA questions were single surgeon personal (39.3%) and medical practice (20.6%) websites. Conclusions: Surgeons may wish to emphasize specific patient education topics, including preoperative factors, cost, and recovery timeline, on their websites to address the most frequently sought-after information regarding rhinoplasty online.
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Affiliation(s)
- Scott N Fassas
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Natalie A Krane
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Jordan G Zonner
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Kevin J Sykes
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - J David Kriet
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Clinton D Humphrey
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
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Sajjadi NB, Shepard S, Ottwell R, Murray K, Chronister J, Hartwell M, Vassar M. Examining the Public's Most Frequently Asked Questions Regarding COVID-19 Vaccines Using Search Engine Analytics in the United States: Observational Study. ACTA ACUST UNITED AC 2021; 1:e28740. [PMID: 34458683 PMCID: PMC8341336 DOI: 10.2196/28740] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/15/2021] [Accepted: 06/20/2021] [Indexed: 01/19/2023]
Abstract
Background The emergency authorization of COVID-19 vaccines has offered the first means of long-term protection against COVID-19–related illness since the pandemic began. It is important for health care professionals to understand commonly held COVID-19 vaccine concerns and to be equipped with quality information that can be used to assist in medical decision-making. Objective Using Google’s RankBrain machine learning algorithm, we sought to characterize the content of the most frequently asked questions (FAQs) about COVID-19 vaccines evidenced by internet searches. Secondarily, we sought to examine the information transparency and quality of sources used by Google to answer FAQs on COVID-19 vaccines. Methods We searched COVID-19 vaccine terms on Google and used the “People also ask” box to obtain FAQs generated by Google’s machine learning algorithms. FAQs are assigned an “answer” source by Google. We extracted FAQs and answer sources related to COVID-19 vaccines. We used the Rothwell Classification of Questions to categorize questions on the basis of content. We classified answer sources as either academic, commercial, government, media outlet, or medical practice. We used the Journal of the American Medical Association’s (JAMA’s) benchmark criteria to assess information transparency and Brief DISCERN to assess information quality for answer sources. FAQ and answer source type frequencies were calculated. Chi-square tests were used to determine associations between information transparency by source type. One-way analysis of variance was used to assess differences in mean Brief DISCERN scores by source type. Results Our search yielded 28 unique FAQs about COVID-19 vaccines. Most COVID-19 vaccine–related FAQs were seeking factual information (22/28, 78.6%), specifically about safety and efficacy (9/22, 40.9%). The most common source type was media outlets (12/28, 42.9%), followed by government sources (11/28, 39.3%). Nineteen sources met 3 or more JAMA benchmark criteria with government sources as the majority (10/19, 52.6%). JAMA benchmark criteria performance did not significantly differ among source types (χ24=7.40; P=.12). One-way analysis of variance revealed a significant difference in mean Brief DISCERN scores by source type (F4,23=10.27; P<.001). Conclusions The most frequently asked COVID-19 vaccine–related questions pertained to vaccine safety and efficacy. We found that government sources provided the most transparent and highest-quality web-based COVID-19 vaccine–related information. Recognizing common questions and concerns about COVID-19 vaccines may assist in improving vaccination efforts.
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Affiliation(s)
- Nicholas B Sajjadi
- Office of Medical Student Research College of Osteopathic Medicine Oklahoma State University Center for Health Sciences Tulsa, OK United States
| | - Samuel Shepard
- Office of Medical Student Research College of Osteopathic Medicine Oklahoma State University Center for Health Sciences Tulsa, OK United States
| | - Ryan Ottwell
- Department of Internal Medicine University of Oklahoma School of Community Medicine Tulsa, OK United States.,Department of Dermatology St. Joseph Mercy Hospital Ann Arbor, MI United States
| | - Kelly Murray
- Department of Emergency Medicine College of Osteopathic Medicine Oklahoma State University Center for Health Sciences Tulsa, OK United States
| | - Justin Chronister
- Department of Internal Medicine College of Osteopathic Medicine Oklahoma State University Center for Health Sciences Tulsa, OK United States
| | - Micah Hartwell
- Office of Medical Student Research College of Osteopathic Medicine Oklahoma State University Center for Health Sciences Tulsa, OK United States.,Department of Psychiatry and Behavioral Sciences College of Osteopathic Medicine Oklahoma State University Center for Health Sciences Tulsa, OK United States
| | - Matt Vassar
- Office of Medical Student Research College of Osteopathic Medicine Oklahoma State University Center for Health Sciences Tulsa, OK United States.,Department of Psychiatry and Behavioral Sciences College of Osteopathic Medicine Oklahoma State University Center for Health Sciences Tulsa, OK United States
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Imbergamo C, Brzezinski A, Patankar A, Weintraub M, Mazzaferro N, Kayiaros S. Negative Online Ratings of Joint Replacement Surgeons: An Analysis of 6,402 Reviews. Arthroplast Today 2021; 9:106-111. [PMID: 34189214 PMCID: PMC8217335 DOI: 10.1016/j.artd.2021.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/09/2021] [Accepted: 05/11/2021] [Indexed: 11/28/2022] Open
Abstract
Background With the expanding accessibility of online health-care information, patients frequently report visiting physician rating websites before choosing a surgeon. As such, it is important to analyze patients’ perception of arthroplasty surgeons as reflected on physician rating websites. Methods A total of 6402 online reviews of arthroplasty surgeons were extracted for analysis. Each review rated less than 5 on a 5-point scale was deemed a “negative” review and was subsequently assigned to an appropriate category. Reviews were stratified by practice type, years in practice, gender, and low (<3) vs high (> 3) ratings. Results A total of 6402 reviews comprising 315 physicians were included in the analysis. The average rating for all surgeons was 4.35. The average rating for physicians in private practice was 4.3, compared to 4.5 for those in an academic setting. The average rating for physicians in practice for 1-10 years was 4.46, compared to 4.03 for those with >10 years of experience (P < .001). The most common factors contributing to negative reviews were bedside manner, wait time, poor outcome, and surgeon proficiency. Surgeon-dependent factors were more commonly associated with lower rated reviews (P < .001). Conclusions Arthroplasty surgeons typically receive high online ratings, with a mean of 4.35 on a 5-point scale. Physicians in academic practice received higher ratings than those in private practice, and physicians who have been in practice for 1-10 years received higher ratings than those with more than 10 years in practice. The most common factors contributing to negative reviews are surgeon-dependent, including bedside manner, poor outcome, and surgeon proficiency.
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Affiliation(s)
- Casey Imbergamo
- Department of Orthopaedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Andrzej Brzezinski
- Department of Orthopaedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Aneesh Patankar
- Department of Orthopaedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Matthew Weintraub
- Department of Orthopaedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Natale Mazzaferro
- Biostatistics and Epidemiology Services Center, Rutgers School of Public Health, Rutgers University, Piscataway, NJ, USA.,Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Stephen Kayiaros
- Department of Orthopaedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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The influence of the internet on the patients' choice of surgeon for their total knee replacement surgery. J Clin Orthop Trauma 2021; 17:186-190. [PMID: 33868916 PMCID: PMC8044677 DOI: 10.1016/j.jcot.2021.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 03/09/2021] [Accepted: 03/14/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND To study the influence of the internet on the patient's choice about Total Knee Replacement surgery and about their choice of surgeon for their Total Knee Replacement procedure. SIGNIFICANCE Insight into patient's decision making will help the surgeon to increase his/her visibility and also will help in providing true and reliable information about the patient's ailment. MATERIALS AND METHODS We studied 200 patients who were operated by a single surgeon. They were given a questionnaire which had various questions regarding their name, age, sex, date of operation. It also had leading questions like did you or your relative searched the net about the operation and the operating surgeon? The information was collected by self filled questionnaire form. RESULTS There were 166 females and 34 males. 70% of to be operated patients or their relatives searched the net before undergoing the Total knee replacement. Also 36% of patient relatives (mainly son or daughter) searched the surgeon on the net before finalizing the operation. 10% of patients searched the operating surgeon on the internet. 15% of patients or their relatives chose the operating surgeon based on their net search. CONCLUSION Our study shows that a sizable number of decision makers (patients and their children) search the information about the operation and about their operating surgeon. Hence it is recommended that the surgeon should have an information portal to increase his/her visibility, patient reach and imparting proper information to the prospective patients regarding the operative procedure.
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